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One of the most important issues this year for emergency medicine physicians — audits — seems to be slipping by without a lot of notice. How is cost containment going to impact emergency physicians? Well, it could put us “up on a RAC,” for starters.
Recovery Audit Contractor (RAC) programs that examine physician documentation for signs that an admission was not justified have “corrected” $1.03 billion in “improper payments” by Medicare in Florida, California and New York. In other words, if you (the physician) have not documented how sick the patient is and how long you intend to treat them, your hospital could be denied the admission, have to pay fines and a third-party auditor could be reimbursed a percentage for finding the problem.
