RACs get rolling: You can expect to receive audit letters shortly

Why This Topic Matters

The rollout affects how Medicare claims may be reviewed, how quickly practices must respond, and what documentation and appeals workload could increase as audits begin.

Article Sections

1. What they are

   Defines the audit contractors and describes the broad structure of the Medicare program overseeing their work.

2. What they'll be looking for

   Summarizes the general types of claims and policy-based issues these contractors are tasked to review, including references to CMS oversight and related audit sources.

3. Expect your paperwork to increase

   Covers the anticipated record-request burden and the limits discussed for different practice sizes.

4. E/M services a target

   Discusses physician evaluation and management claims as an area of attention and the broad concerns raised about audit activity in this area.

5. When you get a RAC request for additional info

   Explains the response timeframe for documentation requests and the option to seek additional time through the contractor.

6. How to respond when the demand letters arrive

   Outlines the general response and appeal timing framework associated with repayment demands, along with related options described by CMS.

7. Official resources

   Lists sources and links referenced for further CMS information and supporting audit reports.