title: Don't think the recovery auditors will disappear.
abstract: Medicare's Recovery Audit program is under scrutiny from all fronts, but the program is so successful, it's not going to go away, so hospitals need to continue to prepare. Make sure that documentation in the medical record shows that the services provided are medically necessary and reflects the severity of illness and intensity of service. Analyze all your denials and appeal those you think are unjustified, all the way to the administrative law judge level, if necessary. Follow screening criteria for patients with targeted diagnoses and make sure physicians are not overusing observation services.
mesh_terms: D019090:Case Management; D014487:Centers for Medicare and Medicaid Services, U.S.; D004469:Economics, Hospital; D007345:Insurance Claim Review; D020416:Outsourced Services; D014481:United States