R.O.A.R.

RAC Operational & Appeals Readiness

DocuComp LLC developed this program specifically for those health care professionals who are involved in maintaining knowledge and compliance with claims processing, reimbursement systems, and the appeals processes within their organization. The program is a comprehensive approach to RAC’s not just identifying the issues but developing a plan of action targeted to correcting the root of the problems that cause the issues.

Data Mining -

• Use claims data to identify specific “weak points” for Inpatient and Outpatient areas
• Review medical records from all risk areas to evaluate “translation” of documentation of services to codes and charge capture processes
• Differentiate technical (software, CDM, etc.) issues from clinical documentation or coding issues

• On-site, individualized evaluation to identify organization-specific processes, systems, and impacts

• Report designed as “guide book” to provide successful implementation of recommendations within scope of the organization’s own systems, resources, and strategic initiatives
• Extensive Exit Conference with the organization’s RAC Response Team and Key organizational Leaders
• Education
  • Physician-to-Physician Program
  • DocuLink Enterprise Program
  • DocuEd Clinical Documentation Improvement Specialist Certification Program
  • DocuEd Denial Management and Appeals Certification Program
  • Targeted RAC Coding, Clinical & Revenue Cycle Training
• Support
  • Medical Record Audits (Inpatient, Outpatient & Physician Services)
  • Case Management & CDI Program Enhancement
  • DocuLink First & Second Level Review Services
  • Clinical Appeals Assistance with Physician & Expert Medical Team