How Staffing Shortages Increase Audits

Healthcare organizations often face staffing shortages in their revenue cycle, adding to the pressure of ensuring proper claims processing. The Centers for Medicare & Medicaid Services (CMS), U.S. Department of Justice (DOJ), and U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) have increased audits to reduce improper payments, using predictive modeling and artificial-intelligence (AI) tools. Risk-based audits rose by 28 percent and prospective audits by 32 percent in 2022.

To ease the burden on revenue cycle management (RCM) teams, a combination of automation, analytics tools, and denial management software can be used for hybrid audits, reducing denials and increasing reimbursements. During the next live edition of Monitor Mondays, Ritesh Ramesh, CEO for MDaudits, will report on how, by leveraging people and technology, internal audits can be conducted faster, errors caught earlier, and staff can focus more on training and optimizing revenue.

Broadcast segments will also include these instantly recognizable features:

• Monday Rounds: Ronald Hirsch, vice president of R1 RCM, will make his Monday rounds.
  
  
• The RAC Report: Healthcare attorney Kyla Wonder, partner at the law firm of Nelson Mullins, will report the latest news about auditors.
  
  
• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.
  
  
• Legislative Update: Matthew Albright, chief legislative affairs officer for Zelis, will report on current healthcare legislation.
  
  
• The Wrapper: John Zelem, founder and CEO of Streamline Consulting Solutions, will join the broadcast for a wrap-up on the morning’s top stories.

Chapters

• 1:30 Ronald Hirsh, MD
• 5:25 Kyla Wonder
• 9:30 ACPA Commercial
• 10:35 David Glaser, Esq.
• 15:02 Matthew Albright
• 19:38 Ritesh Ramesh
• 24:38 RACmonitor Commercial
• 25:28 Q&A with David Glaser
• 27:34 John Zelem, MD
• 29:15 Closing