Recovery Audit Contractors (RACs) are in the process of saddling up for the nationwide roll out of their Medicare payment recoupment mission. Here are twenty-five recommended proactive steps to circle the wagons and defend the RAC threat.
1. Develop and implement a written audit defense plan- the government bounty hunters are coming your way and they will be looking for the low lying fruit.
2. Select an audit team or responsible persons depending upon the size of your organization. Including if appropriate internal audit, billing and coding, medical records, risk management and the CFO.
3. Assign specific team member responsibilities in dealing with anticipated audit issues.
4. Consider running an internal pre-audit to identify vulnerabilities such as “medical necessity” and “duplication of services.”