Recovery Audit Contractor for Medical Billing and Coding Compliance
Authorized by Congress as part of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA), RAC is designed to pursue the identification of Medicare claims which contain non-Medicare Secondary Payer (MSP) improper payments for which payment was made or should have been made under part A or B of title SVIII of the Social Security Act.
How Does RAC Affect Me?
Medicare has engaged recovery audit contractors (RAC) nationwide and in Puerto Rico. The purpose is to identify providers who are submitting incorrectly billed Medicare claims resulting in overcharges. Based on the findings, if regulatory compliance to Medicare billing rules is not up to standard, penalties may be assessed including fines and in severe cases, the loss of Medicare billing privileges.
Will the RAC Companies Really Ever Get to Me?
The RAC companies or contractors are paid on a contingency based fee, so they have every incentive to find incorrectly paid claims which are directly tied to the documentation on the record.
Can McKesson Business Performance Services Help Me if I Don’t Use Your Billing and Compliance Services?
Our consulting team can provide you with an initial Base Line Audit. While this does not prevent the RAC auditor from performing a government sponsored audit, we can identify areas of non-compliance so that you can pinpoint the corrective action needed to meet medical practice billing and coding compliance.