The California Department of Health Care Services (DHCS) and the Centers for Medicare and Medcaid Services (CMS) has contracted with Health Management Systems, Inc. (HMS) to act as the Recovoery Audit Contractor (RAC) for California. According to the DHCS website, “HMS’s mission is to help protect the integrity of government sponsored health and human services programs.” As a RAC, HMS works to identify, audit, and recover improper Medcaid payments for Fee-for-Service and managed care populations. HIM professionals are challenged with navigating and managing this complex environment.
This webinar will provide attendees with clarification on:
- Who is HMS
- Does HMS conduct Medi-Cal or Medicare audits
- Are the notifications paper or electronic
- Subrogation demands when Medi-Cal is secondary payer
- What if the patient’s coverage is Medicare/Medi-Cal
- Are the Additional Documentation Required (ADR) letters for hospital or private practice records
Who Should Attend:
Revenue Cycle Directors and Managers, HIM Directors and Managers, CDI Directors and Managers, CDI Specialists and Leaders, and CFOs. Professionals in inpatient and outpatient settings.
Speaker: Diane Brooks, RHIT, CCS-P