UR or QI nurses with RAC experience?

sknelson · Mar 5, 2009

Hi Gypsy! You spend your Sunday evenings like I have spent hundreds of mine!!! Thanks so much for all the info you have given me. Even though I should be in the "defense" mode--the claims the RACs are taking money back on, especially observation and the one day stays are things I have tried to get through to our administration for a long time. Unfortunately they kept their head in the sand and now it's time to pay the piper!! I won't get to see how our RAC adventure turns out. I am retiring the first of next month but the hospital has hired a consulting group to help them with UR and RACs. Now on Sunday evening I'll be setting on my deck deciding what flowers to repot!!!!!

Sharon

kathtex · Mar 12, 2009

Gypsy--Maybe you can help with this question. Re: obs hours and what is medically necessary. Ex: chest pain r/o mi. Pt placed in obs. Diagnostic tests, such as Echo or Stress Testing, are delayed 24 hrs, but pt is still being monitored on tele. I would track this as an avoidable day for the hospital, but would RAC consider those 24 hours medically unnecessary. Thanks

deutsch79 · Sep 21, 2009

Gypsy, can you tell me what start times and end times my hospital needs to be using to caluculate hourly observation charges? on your ahima document above states that it's when the patient 's medical intervention would end, I take that for an IV being discontinued and d/c instructions being given. Is that right?

d'cm · Nov 4, 2009

ImAgypsy,

I agree with everything you said and would love to do RAC reviews myself. Were you paid per chart / hourly or salary? Did you go onsite / office or work from home?