Catalog Number : cca1629
Title : Understanding Statistical Extrapolation for the RACs
Speaker : Duane Abbey

Webplay Recording Date : 10-1-2009
Webplay Price : $ 225 for two weeks viewing

Webinar Level: Advanced

Webinar Overview:

This workshop discusses the formal statistical process of extrapolating or extended the results of a limited audit to a much larger universe in determine overall overpayments. This presentation is based on the use of the OIG’s free software, RAT-STATS. This extrapolation process is also used by other governmental agencies such as the OIG and the DOJ.

Target Audience:

• Education/Training Personnel
• Chief Compliance Officers
• CBR Compliance Officers
• Healthcare Auditors
• Healthcare Compliance Personnel
• Chargemaster Coordinators
• Billing and Claims Generation Personnel
• Patient Financial Management Personnel
• Cost Accounting Personnel
• Cost Report Personnel
• Financial Analysts
• Managed Care Contract Personnel
• Revenue Enhancement Personnel
• Chief Financial Officers
• Financial Planners
• Medical Staff Directors
• All Other Hospital Personnel Interested in Compliance

Webinar Objectives:

• To Provide a Brief Overview of the Medicare Recovery Audit Contractor Program
• To Discuss the Formal Statistical Process of Extrapolation of a Selected Sample to a Larger Universe
• To Explain The Use of the OIG’s RAT-STATS Program for Determining Sample Sizes, Confidence Intervals, and Precisions Levels
• To Review The Process of Using Probe Audits To Establish an Error Rate As Input to RAT-STATS For Determining Sample Sizes
• To Understand The Process of Determining the Final Overpayment Amount Using the Confidence Interval
• To Appreciate The Need To Carefully Analyze Any Overpayment Demands Based on Extrapolation

A few of the Topics that will be covered:

• CMS RAC Program
  • Objectives of the RAC Program
  • Techniques and Methods Used by the RACs
  • Scope of RAC Program
• Statistical Background for the Extrapolation Process
  • Universe Identification
  • Probe Audit To Determine Error Rate
  • Determination of Sample Size
  • Confident Intervals
  • Precisions Levels
  • Extrapolation of Results
• RAT-STATS
  • Features Needed for Extrapolation
  • Downloading and Using RAT-STATS
• Overpayment Calculations Using Extrapolation
  • Confidence Interval Important
  • Analyzing the Proper Use of Extrapolation
• Sources for Further Information

Prerequisites for Participating:

• A general understanding of health care compliance, the RACs, the OIG Work Plan and coding, billing and reimbursement compliance. Some statistical background is extremely useful.

Attendance Certificate: Upon attending this course you will receive a 1.5 Contact Hour Attendance Certificate. There is usually a reciprocal agreement between state associations to allow these to count for each state. If you have any questions, please ask your state association.

Full tuition is refunded immediately on request if the participant has not been sent the program materials and instructions. Once the instructions (including access codes) have been sent, a full refund will be issued only after the program runs and it is verified that the participant did not access the program.