Editor’s Note: Over the coming weeks leading up to the conference, we’ll take some time to introduce members to a few of this year’s speakers. The conference takes place May 9-12, at the MGM Grand in Las Vegas, Nevada. Today, we spoke with Barbara Brant, MPA, RN, CCDS, CDIP, CCS, a senior consultant with Cotiviti Health Care, presenting “CDI Specialists: Impact Potential in the Audit Process.” Since 2005, she has been involved in the development, implementation, and auditing of CDI programs. Brant has assisted health systems with ICD-10 Gap Analyses and created ICD-10-CM educational materials for specialty physician groups. Currently, she provides training and clinical support for DRG auditors. She lives in Camp Hill, Pennsylvania with her husband Marty.
Q: What do you think CDI specialists’ biggest misconceptions about the Recovery Auditor program are?
A: There are really three main misconceptions:
- Denials are determined without complete review of the documentation
- Recovery Auditor’s only look for “gotcha” errors
- CMS Recovery Audit programs are performed to only take back
Q: Recovery Auditors are not at the top of anyone’s best friend list in healthcare, but what important purpose do they serve?
A: The goal of any audit is to identify problematic issues. The purpose of CMS’ Recovery Auditors is to identify and prevent improper payments. Therefore, Recovery Auditors serve a purpose by encouraging healthcare providers to work for solutions to correct identified problems, stabilize provider revenue cycles, and ensure accurate payments for payers.
Q: What are three things attendees can expect from your session?
A: The three things that attendees can expect are
- To understand that Recovery Auditors perform very comprehensive reviews of all documentation provided.
- To obtain knowledge that the guidance for recommended reimbursement changes (higher or lower) is based on extensive peer-reviewed research of best-practices, clinical consensus data and Official Coding Guidelines.
- To use information from this session for improved denial data due to CDI performance improvements.
Q: In what ways does your session challenge CDI professionals to think outside the box?
A: To encourage use of retrospective audit data to concurrently improve problematic documentation
Q: What are you most looking forward to about this year’s conference?
A: Interaction with colleagues and to stay updated on CDI’s expanding roles within the revenue cycle
Q: Fun question: what’s your favorite movie?
A: A Christmas Story – a perfectly imperfect loving family!