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– Nelson Mandela

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Lesson 13 Forum - Team 1

Lesson 13 Forum - Team 1

Q Review the RAC information located hereLinks to an external site.. From here you can also click on the RAC websites to learn more, as well as approved and proposed topics. Describe the RAC process. How can providers and facilities prepare for a RAC audit? What key points can be identified and then implemented at the coder, physician, and clinician level to improve reporting processes? Any questions concerning this lesson or the textbook material should be posted to the link titled Ask Questions About L13 Here. I actively monitor that forum for student questions. Please do not request quiz answers or clarification to quiz answers until AFTER the quiz has closed, and you have had a chance to review the correct answers. If, after you have seen the correct answers you still have questions, you may post them to the link titled Ask Questions About L13 Here.

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The Recovery Audit Contractors (RAC) review potential overpayments or underpayments. They focus more on areas identified by the Comprehensive Error Rate Testing (CERT) as likely to have errors. The RAC process begins when thy identify the risk pool of claims. Secondly, medical records are requested from the provider. RAC review the claim and the medical records concurrently. After the review, RAC decides whether there has been an underpayment, overpayment of the correct payment. For an overpayment, files are sent to Medicare Administrative Contractor (MAC) to adjust the claim and recoup the payment.