Monday, April 26, 2010

"The RATS Are In the House"

I'm not sure I've heard a term that describes the OIG's audit teams that performs inpatient chart reviews better. The name stems from the Office of Audit Service's software used to determine how many charts to review at each facility:
RAT-STATS is the primary statistical audit tool used by the Office of Audit Services. Developed by the Regional Advanced Techniques Staff (RATS) in San Francisco, it has been used by the Office of Inspector General since the early 1970s. With the arrival of microcomputers, there was opportunity to move the statistical software from the mainframe timeshare systems.

In September 1987, the first microcomputer version of RAT-STATS was developed to run on IBM compatible computers using Microsoft's Disk Operating System (MS-DOS).
And like rats, these chart review teams are replicating like crazy.

After all, the cat and "mouse" game of finding evil doctors fraudulently billing by forgetting to note if heart failure is acute or chronic and systolic or diastolic must continue.


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