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Special guest on Monitor Monday this past week Jon Elion, MD, the president and CEO of ChartWise spoke on the subject of the Mismatch RAC Trap, asserting that the core issue is inadequate clinical documentation. Dr. Elion was referring to what is oftentimes said but not billed. He went on to quote from CMS — a quote that sent a number of listeners scrambling to get their pens to write down the five reasons why RAC denials occurred because the documentation was not sufficient. Here they are — and they’re worth repeating — why the documentation was not accurate enough to…1) support the diagnosis, 2) justify the treatment/procedures, 3) document the course of care, 4) identify treatment/diagnostic test results, and 5) promote continuity of care among health care providers. 

Chuck Buck

Chuck Buck is the publisher of RACmonitor and is the program host and executive producer of Monitor Monday.

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