Be Prepared for RAC Audits

Posted by Jesse Baguchinsky on Dec 20, 2016 3:20:57 PM


Healthcare providers are no strangers to the RAC (Recovery Audit Contractor) audit program. Since 2009, the Centers for Medicare & Medicaid Services (CMS) has awarded contracts to private companies to review Medicare claims and recover potential overpayments. We’ve all recently had a welcome break from RAC audits, but that’s about to change. Last month, CMS awarded new contracts to several companies, and a new wave of audits is set to begin as early as January!

While these new contracts mean that RAC audits are back, rest assured that some limitations will give you a little breathing room. For example, instead of having to go directly to the appeal process, you now have a 30-day window to review and submit counter evidence to avoid overpayment reclamation. Also, the RACs can only review claims that are less than six months old, as opposed to three years (whew!)


Even with these new rules, having a robust audit management process could save you time and give you a head start on responding to post-payment reviews. Fortunately, our Engage Audits & Denials solution can help. This tool has a full set of detailed RAC audit features that provides in-depth reports and identifies overpayments before the actual payment adjustment. This lets you preemptively report the impact to your cash flow and better prepare for the appeal process.

Engage Audits & Denials also lets you delegate workloads to your team. Your people can transfer required documents through our secure, HIPAA-compliant esMD gateway. This dramatically cuts down on the time everyone spends responding to RACs.

If you’d like to see our RAC reporting features in action, we’d like to invite you to check out our WebEx demo. We also offer a 30-day, risk-free trial of Engage Audits & Denials so you can take a test drive managing your own audit response. If you’re not convinced after the trial, you can terminate the service at absolutely no cost to you.

Just click the button below to get started today. You can also call our Client Services department at 866-633-4726 if you have any questions.


Topics: Audit Management, rac audits, Engage Audits & Denials