Get ready for a RAC attack

Description

Abstract: Medicare’s Recovery Audit Contractor (RAC) programs are now operational in all 50 states — and beginning Jan. 1, 2012, all states must have RAC programs in place to identify improper payments for Medicaid services. Furthermore, the audits are now focusing on outpatient settings as well as inpatient. So all physician practices that submit claims to these federal programs will likely be reviewed at some point by a RAC. This article shows what happens if a RAC determines an overpayment has been made to a practice, and how the appeal process works. It also shows how to prepare for an audit, while a sidebar lists the four RAC contractors and their assigned territories.