The 7 Habits of Highly Effective RACs

Or What the RACs Borrowed from The Walking Dead

The 7 Habits of Highly Effective People? [Pfft.] That’s so 80s.

I have it on good authority that the RACs are huge fans.

I have it on good authority that the RACs are huge fans of these shows. Makes sense to me!

There’s another, more timely source you could learn a whole lot more from. Zombies. Not pretty… but hey, based upon their sheer numbers, they are some of the most effective once-upon-a-time-I-was-a-person people around. And all this time, you thought they were only good for entertainment or devouring your least favorite Presidential candidate.

You must admit, however, that while Zombies may not have feelings, they are pretty good at getting what they want. So. Decaying flesh and rotting teeth aside, we can learn a lot from the undead.

And it is my contention that RACs have already done exactly that. To wit… here are the seven habits that I see the RACs have already adapted from the undead.

Habit 1: Be Relentlessly Confident

Nothing, but Nothing stops a zombie. Uh. I think that's admirable. I think.

Nothing, but Nothing stops a zombie. Uh. I think that’s admirable. I think.

Ever seen an insecure, self-doubting zombie? Neither have I. RACs act the same way!

Zombie-talk you’ve never heard:
“I’ll never be able to catch that human. My stupid, dead limbs just won’t move fast enough. My tattered clothes are so embarrassing. I’m just not good enough.”

RAC-talk you’ll never hear:
“I’ll never be able to deny all these claims. My stupid, dead CMS handlers just won’t approve everything I come up with. My self-righteousness is so embarrassing. I’m just not good enough to save the Medicare Trust Fund.”

Ok, sure, like zombies, RACs are devoid of feelings, but that’s beside the point. When it comes to getting what you want, your attitude could benefit from an overhaul, dare I say, an infection of the attitude of the undead. They are relentless!

So inpatient claims were denied? Your ICD-10 claims are somewhere in Zombieland, wandering aimlessly? Your queries are going unanswered?

Don’t let it stop you from trying again. And again. And again. Pursue your dreams like a zombie would: relentlessly and without fear of failure.

Habit 2: Get the Respect You Deserve

Payday. Arm yourself. Know your weapons, keep them handy. Fight them enough, they'll respect you. (Ok, unless they really are undead.)

Payday. Arm yourself. Know your weapons, keep them handy. Fight them enough, they’ll respect you. (Ok, unless they really are undead.)

Say what you want about zombies, but when it comes down to it, the one thing they’ll always have is your respect. And I mean respect, like the kind of respect you have for a Doberman staring at you from two feet away. You innately know that if you see a zombie, you have two options: Get the @#$% out of there or kill it. There’s no negotiating, there’s no “she’s just sick, doesn’t know what she’s doing,” there is NO middle ground.

Zombies are incredibly good at their job (seek out humans, eat them, and/or turn them into zombies) and humans have come to respect – and fear – that. Well, in the same vein (sorry, couldn’t resist the almost-pun), if you work hard to gain the respect of those around you, including employees, co-workers, and even third-party personnel, you’ll go a lot further in business. It should go without saying, but there’s a huge difference between getting respect and scaring people. Always aim to be the type of person people gravitate toward rather than the type people run like mad to get away from.

So the RACs have taken this to heart (seek out providers, kill them with denials, and/or turn them into whistleblowers), but the only ones they care about getting respect from are the Head Zombies at CMS. You, on the other hand, are concerned with the folks who still have blood coursing through their veins, the people you work with at your hospital. Mostly. Before you retire or leave the industry. Or… never mind.

Habit 3: Be Meticulously Thorough

Round 'em all up. Leave no gaps in your defenses. Stay vigilant! And thumb your nose at them.

Round ’em all up. Leave no gaps in your defenses. Stay vigilant! And thumb your nose at them.

Would a zombie ever leave a job undone? Give up? Cut corners? Nope. It’s just not in their DNA. (Or whatever a dead thing has.) I admit, while zombies at work are kind of gross to watch, they are nevertheless, day in and day out, as thorough as they can possibly be. In fact, the only thing that’ll stop a zombie from eating every last bit of a victim is a shotgun blast to the head. Or an ax. Or a crossbow. But you get the idea.

And while you’d never want to be so thorough that someone has to kill you to get you to stop doing your job, taking even the slightest undead approach to your work can be a good thing. (As long as you don’t get too carried away… I know you’d like to see a zombie outbreak at your friendly neighborhood RAC office, but remember to be careful what you wish for…)

When you’re as thorough as a zombie, you’re more effective. Period. (Just try to be a little less messy. Ok, a lot less messy. Besides, who’s going to do the clean up?)

Again, the RACs are more than thorough. If they even find a HINT of a reason to deny, they deny. No partial denials or convert to Part B and pay that. Nope. All or nothing. And of course, they are so thorough that they err on the side of error – they are wrong 77% of the time. (Actually, I have another adjective in mind, but it’s not appropriate here.)

You, on the other hand, have a chance to improve how claims are done before they go out the door. I know – easier said than done. The good news, however, is that for the denials that are actually correct, they are almost all avoidable. You therefore have a chance to be THE champion of change. Visible, tangible, valuable change. Take heart! You are an Agent of Change.

Habit 4: Listen Intently

Be like Daryl. Learn to listen, but ride a big noisy bike and let 'em bring it.

Be like Daryl. Learn to listen, but ride a big noisy bike and let ’em bring it.

One of the best (or worst?) traits of a zombie is the fact that those dead suckers can hear better than any living creature, hands down. Oh, a baby is crying five miles away? A person accidentally dropped a plate on the ground? You can bet your clumsy butt that zombies will be on the move and arriving shortly. How fast they arrive, of course, depends on if these are the dumb, slow zombies (my personal fave) or the smarter, faster zombies (in which case, pucker up, you don’t stand a chance).

Becoming a great listener will undoubtedly help you learn and grow, as a person. And assuming you don’t have rotting flesh, you can even do it without terrifying everyone around you.

RACs listen intently. Oh, not to providers… they listen to the data… and they can hear it all, every whisper, every little cough… They have the whole database at their beck and call. As a provider, you don’t need all that, but you can actually take advantage of what the RACs are hearing, because they have to tell you about it, albeit after the fact. But their approved issues lists, while still difficult to track, are a veritable chorus, a symphony of all the things that attract their attention… just like the sounds that attract the walking dead.

So make sure you pay attention to the reports that come from CMS about what the top denials are, even if they’re not in your region. You really think you’re okay just because they haven’t hit you with any of those so far? Why? Have you checked your own claims for those issues? If you have, then you are listening intently… good job!

Habit 5: Turn on the Charm

Charming. Don't care much for Rick, though.

Charming. Don’t care much for Rick, though.

Charm comes in all shapes and sizes. In this case it’s wearing blood-soaked clothing and has a strangely loveable gait.

Their hearts may no longer beat, but, somehow, zombies have stolen a little bit of ours. Movies about the undead literally kill us at the box office, yes? The Walking Dead slays TV audiences every season. The Talking Dead is a highly popular zombie-themed talk show. Now we have Fear the Walking Dead. And people even write weird zombie-themed blog posts (like this one) – all despite the fact that the undead are truly relentless killing machines with absolutely horrible personal hygiene and freakishly good hearing.

What’s the point? That zombies must have a certain ‘je ne ses quoi,’ or they wouldn’t be such a success in our popular culture today. Despite their blood-soaked clothing, empty eyes, decaying teeth and rotting flesh, zombies are somehow still able to charm us into continually giving them ratings. Of course, being charming, in a human’s case, can have a slightly different outcome. (Although we all know some who might better qualify as spiritual vampires, huh? Ok, maybe it’s just me.)

When you’re a charismatic person, you’ll go further in business, make stronger connections, and have a much better chance at staying employed and profitable no matter what the economic climate is. (No apocalypse necessary.)

The RACs, and certainly CMS, very often try to turn on the charm, in front of providers, the press, and even Congress. (Note: Lobbyists are another type of creature that has learned to exude charm, but I liken them more as true Vampires, so that’s a post for another day.) It remains to be seen if Congress has more recently finally seen through this façade or not.

In your own workplace, and certainly in dealings with payors, there is something to be said for charm – especially for whomever is tasked with Peer-to-Peer and/or Discussion Period engagements. Social media offers the chance to even tailor the when, what and why of charming someone on the other end of the phone. Hey, it might even work on an ALJ, who knows. Worth a shot.

Actually, now that I think of it, charm doesn’t work on the undead, so it may not be helpful for trying to work with the RACs, since they are, in all likelihood, actually undead. But … not all your dealings will be with the RAC. Thank goodness!

Habit 6: Become a Networking Expert

Bad sign. Don't need to count!

Bad sign. Don’t need to count! Numbers do lend strength.

Zombies tend to travel in packs. On occasion, you may see a lone straggler here and there, but for the most part, you can consider them to be (undead) herd animals. Why is this? Well, zombies are stronger, and much more effective, when they’re in a big group. One zombie in a field? No problem. Ten zombies in a field? If you have an AK-47 and extra clips in your hands, maybe, but otherwise, time to run.

The same goes, in general, for humans. When you team up with other humans, you collectively become much stronger. Strength in numbers, and all that. As Napoleon said, “God is on the side of the big battalions.” Whether it’s by reading and writing on listservs like rac-relief, contributing and reading AHA’s RACTrac, learning from your boss’s expertise, or by supporting your co-workers, you’ll find that your journey as a professional will be much smoother and hopefully, more profitable, than it might have been otherwise.

And hey, if there does happen to be a zombie apocalypse at some point, you’ll at least have a bunch of new friends around to help you shoot all those relentless zombies in the head. And remember… keep those Case Managers close at hand… ‘cause they are tough!

Habit 7: Dare to Be Different

The one character they simply can NOT kill off or there will be widespread riots.

Redneck or not, Daryl is the one character they simply dare NOT kill off or there will be widespread riots, all over.

Maybe the reason zombies have been able to remain popular over the years is because they are so different from all other monsters out there. After all, there are ghosts, demons, vampires, sea creatures, grim-reapers, presidential candidates, you name it, but none just flat-out stalk humans 24/7 like zombies do. Ok, the presidential candidates are persistent, but they do take short breaks in between elections. Kind of.

And there’s this, too: is it broad daylight? Zombies couldn’t care less. Middle of the night? Zombies aren’t afraid of the dark. Politicians even to seem to prefer the dark. Humans are never fully safe from zombies, no matter where they are, what time of day it is, or what type of weapon they have to protect themselves. And unlike politicians, if you insult a zombie, they won’t just smile and move on to the next victim, they don’t care and just keep comin’.

Anyway, it’s the very habits that make zombies different from other monsters that are the same ones that have made them – strangely – likeable! Being different, unique, special, whatever you want to call it, sets you apart. Yes, you may take a risk, but the alternative looks a lot like getting in line behind all the others who have chosen to play it safe, and hoping, somehow, you still get noticed.

Whether it’s with your ICD-10 transition plan, your staffing idea to reduce a coding backlog, your documentation education plan for your hospitalists, or anything else, when you dare to be different, you dare to go further than all the rest. And — you just might tear apart (figuratively) the competition (the way things are done now) while you’re at it.

The RACs, again… I’m tired of admitting it, are truly different. They are paid to find errors and make denials. Unlike the other contractors, they are ONLY paid if they deny.

So for you? Get out of your comfort zone. Make a radical plan – just make sure it does what you say it will do and doesn’t cause other problems that are worse than the one you are solving. And then make your presentation to the bosses in a different way… figure out what THEY lose if they don’t adopt your plan. I repeat… what THEY LOSE.

Life Lessons from the Lifeless

Don't care for Zombies? Ok, well, you might learn something from Game of Thrones, then. Not quite as depressing, eh?

Don’t care for Zombies? Ok, well, you might learn something from Game of Thrones, then. Their story line is not quite as depressing, eh?

Really, the bottom line from what you’ve learned here today is simple: Nobody puts the undead in a corner. Zombies fight for what they want – and usually always get it – because nothing, and I mean nothing, can shake their confidence.

What if you attacked your day with that same mentality? In fact, applying these habits to your life, both professionally and personally, will help you to become a more effective, happy, and successful person overall.

Here’s a final thought: How is it possible that brain-dead zombies can teach the living so much?

I submit that zombies don’t over-think things. They’re not paralyzed by obstacles – not even death!

They act.



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