RAC payment recovery program to roll out nationwide

Why This Topic Matters

RAC activity can affect Medicare reimbursement, documentation practices, and compliance workflows for medical offices. Understanding the program’s expansion helps practices anticipate audit pressure and strengthen internal review processes.

Article Sections

1. Testing the waters

   Background on the RAC pilot program, including its early implementation and the federal legislation connected to its expansion.

2. How they operate

   A general explanation of how the audit contractors review claims and request records when potential payment issues are identified.

3. Self-audit to find deficiences

   Discussion of internal compliance review, audit preparation, and broad practice-management steps intended to reduce exposure to audit findings.

4. Check these problem areas

   A summary of broad billing and compliance areas that practices are encouraged to monitor more closely.