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The Recovery Audit Contractor Workbook is a practical guide to assist all providers participating in Medicare to prepare for a potential RAC audit.
- Preparing for a RAC audit, including establishing the internal structure and authority to manage the RAC audit process
- What to do during a RAC audit, including proper ways to respond to RAC demands and requests, tracking documentation, and preparing for appeals
- What to do after a RAC audit, including conducting a risk assessment and developing corrective actions
- Helpful charts, sample letters and forms to help you prepare for RAC reviews and appeals process!
The workbook includes several helpful charts explaining the RAC review and Medicare appeals process. It also includes several sample letters and forms that providers can use to prepare their organizations for RACs, to communicate with RACs and to establish new internal policies for their organizations.
I. Introduction
A. Objective
B. The RACs in Context
C. RAC Background and Implementation
II. Preparing for a RAC Review
A. Developing Internal Processes and Operations
B. Conducting Risk Management
III. What To Do During a RAC Audit
A. Respond to RAC Medical Records Requests
B. Review the Findings of Your RAC Audit
C. Filing Rebuttals and Appeals
D. Tracking RAC Requests and Your Responses and Appeals Filings
IV. What To Do After a RAC Audit
A. Develop Corrective Actions Based on Your RAC Findings
B. Audit and Monitor New and Revised Internal Controls to Assess the Effectiveness of Corrective Actions
C. Debrief on Internal Process and Report Findings
D. Reporting to the Board of Directors
V. Closing
Appendix A: Medicare Modernization Act (Sec. 306)
Appendix B: Tax Relief and Health Care Act of 2006 (Sec. 302)
Appendix C: Key Dates
Appendix D: RAC Medical Record Request Limits
Specifications
Book: Pub. January 2009, 92 pages. ISBN: 978-0-8080-2049-3 |
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| SKU |
RMEB-RACW09 |
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