decisionhealth Newsletters, Part B News - 2009 Issue 8 (August)
4 tips to handle increased carrier audits along with RAC reviews
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Article Overview
This piece covers provider preparation for increased audit pressure tied to the permanent RAC program and related carrier or MAC reviews. It presents broad guidance on internal compliance review, overpayment handling, reopening challenges, and appeal readiness, aimed at billing, compliance, and revenue cycle professionals following Medicare audit activity.
Why This Topic Matters
Audit activity can affect claim payment, compliance exposure, and refund handling. The article is relevant to organizations that want to understand the operational implications of RAC-related reviews and related Medicare contractor scrutiny.
Article Sections
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Preparing for the permanent RAC program
Introduces the expected increase in audit activity and the need for earlier internal preparation when the permanent program begins.
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Four-pronged preparation strategy
Outlines the article’s high-level preparation themes for providers facing contractor reviews and related payment scrutiny.
What You Will Learn
- How the article frames the relationship between RAC activity and other Medicare contractor reviews
- What kinds of internal preparation the article emphasizes
- Why overpayment identification and refund handling are discussed
- Why reopening and appeal readiness are important topics in audit response
Who Should Read This
- Medical billing professionals
- Compliance officers
- Revenue cycle managers
- Provider practice administrators
- Healthcare auditors
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