Note from the speaker: Stay abreast of auditing issues at RIS

Wednesday, September 18, 2019

by Alicia Kutzer Esq., LL.M., MHA

The Revenue Integrity Symposium (RIS) provides healthcare executives, clinicians, and other professionals a friendly and welcoming forum to learn a great deal from subject matter experts through engagement and interaction with speakers. It is a one-stop-shop for healthcare professionals to network with leaders in the industry. This year’s symposium will be held October 15–16 in Orlando.

I have visited Orlando several times and I always enjoy the energy of the city. There is so much to do and see in Orlando, and I am especially excited to enjoy festive outdoor restaurants and renowned shopping centers. I am also very excited to stay at the Renaissance Orlando at SeaWorld. RIS attendees can take advantage of special Disney park rates to enjoy some downtime after valuable learning and networking. 

Meet the experts

The speakers at RIS are top-notch and, undoubtedly, have spent countless hours deep-diving into the topics they present. In my opinion, the level of expertise that speakers at RIS have is unmatched, and attendees will not be disappointed by this year’s speaker selection. These expert speakers guide attendees through the arduous task of reviewing CMS’ ever-changing policies. Attendees will leave each session armed with current information and insight so that they may ensure their organizations are in compliance with CMS.

In addition to being a phenomenal learning experience, RIS is organized by some of the most amazing event planners that I have ever had the pleasure of working with.

A look at the agenda

There are many sessions I am looking forward to. After reviewing the agenda, I am intrigued to attend the session “Today’s World Of Audits And Reviews: A Look at CMS’ Audit Programs, Their Contractors, and Other Federal Oversight” presented by Diane Weiss, CPC, CPB, CCP, CHRI, vice president, reimbursement, for RestorixHealth in Metairie, Louisiana.

As a healthcare attorney and former Administrative Law Judge, I do everything I can to stay abreast of auditing issues, so I am excited hear what Diane has to say, especially since she has such extensive knowledge of the current state of audit affairs. Another reason that this session is a must see for me is because as an instructor for HCPro’s Medicare Boot Camp® — Audits, Appeals, and Denials Version, this session may provide me with additional information that could lead to rich discussions during the boot camp. Please consider sticking around after RIS to join me as I present this boot camp as part of our post-conference educational activities from October 17–18.

I hope you will also join me on day two of the main conference as I present the session “Target Probe and Extrapolate: A Concerning CMS Initiative.” Each Medicare Administrative Contractor (MAC) is responsible for leading this program in their jurisdiction.

CMS indicated that most providers will not undergo TPE audits. Facilities with high billing error rates or aberrant billing patterns may catch the eye of their MAC and be asked to educate staff and improve billing processes. Here’s the scary part—if a facility continues to experience high billing error rates after providing education to its staff, the MAC can require that the facility then undergo 100% prepay review, extrapolation, referral to a Recovery Auditor, and other actions. Extrapolation and 100% prepay review will likely result in financial distress for the facility. My session at RIS will provide an overview of the TPE audits and offer best practices for audit preparedness.

See you at RIS!


Editor’s Note: Kutzer is an adjunct instructor for HCPro’s Medicare Boot Camp — Audits, Appeals, and Denials Version, Medicare Boot Camp – Hospital Version, Medicare Boot Camp – Utilization Review Version, and Medicare Boot Camp – Critical Access Hospital Version. Kutzer is a licensed attorney in the state of Pennsylvania and is a managing partner of Kutzer Law Firm, LLC, located in the Wilkes-Barre/Scranton area and founded in 2011.

NAHRI members get a $100 discount on registration to the 2019 Revenue Integrity Symposium. Professionals wishing to earn support from program administrators to attend the 2019 Revenue Integrity Symposium may adapt our justification letter proposal.

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