Note from the speaker: Learn the ins and outs of AUCs from the experience of a major academic medical center

Wednesday, July 31, 2019

by Angela Lynne Simmons, CPA

The January 1, 2020, deadline for reporting Appropriate Use Criteria (AUC) for advanced diagnostic imaging is fast approaching—but organizations can’t wait until the new year to prepare. New processes, procedures, and policies need to be tested and ready to go to meet the requirements and to ensure disruptions to patient care and operations are kept to a minimum. Organizations should have a thorough understanding of the rules, the impact on the organization, and compliance risks before the AUC program goes into full swing.

That’s why smart organizations took advantage of CMS’ voluntary reporting period to develop and manage AUC reporting program. Complying with AUC consultation and reporting requirements necessitates new processes for providers and CMS, so the agency designated 2019 a voluntary reporting period during which organizations could choose to report AUC consultation information for informational purposes only. This is a valuable opportunity for providers and CMS to get in early and work out the bugs before the requirements officially launch.

Get an inside look at how to develop and manage an AUC reporting process during my session at the 2019 Revenue Integrity Symposium (RIS), to be held October 15–16 in Orlando, “Appropriate Use Criteria for Advanced Diagnostic Imaging: Understanding the Requirements and Impact on Operations.” Co-speaker, and fellow NAHRI Advisory Board Member, Denise Williams, COC, CHRI, and I will explain AUC essentials, covering the basic concepts and information from CMS, as well providing examples of how to put proven processes into place at your organization. These are new rules and everyone must comply, so attendees need to understand and ensure their facility is in compliance. I’m looking forward to the opportunity to share our work with our revenue integrity peers. Creating the presentation and preparing to speak on the topic has helped me become familiar with the AUC process inside and out—something we’ll all need to do.

RIS has been on my radar since it began, and last year I had the opportunity to join a panel of my fellow NAHRI Advisory Board members to discuss the latest revenue integrity hot topics. That sparked a fun and lively discussion, and attendees joined in during the Q&A portion with excellent questions. I’m always impressed by depth of knowledge and desire to learn more that revenue integrity professionals demonstrate. Every year, I enjoy the sessions very much and always bring away major nuggets of wisdom that I can use at my organization.

The symposium is also the perfect chance to catch up with old friends, make new friends, and connect face-to-face with colleagues you’ve spoken with but haven’t had the chance to meet in person. Last year, I was grateful for the opportunity to build and strengthen my relationship with other Advisory Board members, including Valerie Rinkle, MPA, CHRI. She and I met there and have since became good friends. We help each other out all the time. 

Click here to see the full agenda and pick out your must-attend sessions. I hope to see you there!

Editor’s note: Simmons is the vice president of revenue and reimbursement at Vanderbilt University Medical Center. She serves as an advisory board member for NAHRI.

NAHRI members get free admission to a special members-only networking reception on October 14, the night before RIS officially kicks off. NAHRI members attending this reception should RSVP online as soon as possible to reserve their space.

Register for the 2019 Revenue Integrity Symposium before August 17 to get the $100 early bird discount. NAHRI members get an additional $100 discount. Need help getting approval to attend? Click here to download a justification letter proposal that you can use to gain administrative support and approval for attending.