Rac Audit, or Recovery Audit Contractors explained

Recovery Audit Contractors, or RAC’s, are being utilized to help stem the tide of Medicare and Medicaid overpayments to healthcare providers.  With lucrative incentives in place, Recovery Audit Contractors have increased motivation to review, in depth, a doctor’s records in their attempt to discover even the smallest instance of fraud.  The days of undercoding in an attempt to avoid drawing attention, are at an end. RAC audits are designed to delve deeply into your medical records and only being completely organized and prepared will help stave off possible financial punishment.

If your practice incorporates an in-house document management operation, your chances of emerging from a RAC audit unscathed are crippled.  The difference between taking care of your business’s records or entrusting a professional records management service with those same records comes down to time and experience.  It is difficult to run a successful business if you have to spend a healthy portion of your time impeccably organizing your records and ensuring that your employees do the same. RAC auditors earn commission for the more fraud they find much like a salesman is rewarded for making more sales, meaning if everything is not in its correct place and your employees are not prepared for the intensity of an audit, there’s a good chance that you’ll end up owing money or worse. 

Document management services know the importance of being prepared for a RAC audit.  It is their job to be organized and to provide the means of ensuring the safety and accessibility of your important information so that you don’t have to.  A good service will not only feature state of the art storage facilities, but will have trained employees with RAC audit experience and technology like Scan on Demand to make sure that accessibility meets the necessity for speed.  Try running a sample audit of yourself and chances are you will find that neither you nor your business’s employees are prepared for the ensuing process.  Research records management services to find out what they have to offer, because the hurdles that exist and the possible financial consequences that come with a RAC audit are far too high to entrust to undercoding and amateur organizing.

In summary:

1.       Undercoding provides no immunity

Have a frank discussion with the coding and billing team regarding documentation

2.       Ensure that your charts are complete and accessible

Last minute hysteria harms a practice or a hospital more from shifting focus from the patient

3.       Orientate your staff for the audit

Practice finding random charts and audit them to the billing

4.       Make the “EOB” explanation of benefits part of your files

5.       Audit a sample of charts with a medical professional to ensure documentation of medical necessity