tci Medicare Compliance & Reimbursement - 2017 Issue 8
Prepare Ahead of Time for a RAC Audit with These Practice Basics
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Article Overview
This article covers general practice-readiness measures for Recovery Audit Contractor (RAC) audits. It explains why audit preparedness matters, who should pay attention, and the broad categories of compliance and recordkeeping guidance a practice may want to review, including policies, documentation quality, self-audits, and monitoring of agency publications and payer guidance.
Why This Topic Matters
RAC audits can create operational and financial disruption if a practice is unprepared. The article helps readers understand the kinds of administrative safeguards and documentation practices that support audit readiness.
Article Sections
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RAC audit preparation basics
Introduces practical steps for organizing a practice to respond to audit activity. Focuses on general recordkeeping, workflow, and compliance readiness.
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Monitoring audit guidance and publications
Describes the importance of tracking relevant oversight sources and published guidance from federal, regional, and local payer or agency channels. Emphasizes staying current with changing audit-related information.
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Internal audit readiness and documentation management
Covers internal preparation activities such as self-audits, assigning responsibilities, preserving records, and ensuring documentation is readable and properly authenticated.
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Common audit triggers and response priorities
Discusses broad factors that may draw audit attention and the value of quickly assembling requested documentation. Focuses on general response preparedness rather than case-specific guidance.
What You Will Learn
- How practices can organize themselves for audit readiness
- Which types of guidance sources are commonly monitored for audit-related updates
- Why documentation quality and record authentication matter in audits
- How internal roles and self-audits support compliance preparation
- What broad issues can prompt audit review and why prompt response helps
Who Should Read This
- Medical practice administrators
- Billing and coding staff
- Compliance officers
- Physicians and other providers
- Healthcare attorneys and consultants
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