Comprehensive Revenue Solutions

18645 SW Farmington Rd. Suite 126
Beaverton, OR 97007
Phone: 888.698.3999
Fax: 866.966.6648

RAC Baseline Audit

Medicare RAC Auditors Are Coming!
Are You Ready?
The Recovery Audit Contractor (RAC) is a program designed to detect and correct improper past payments made on claims of health care services provided to Medicare beneficiaries. For some Healthcare providers, DME providers and home health agencies, Medicare can represent 75% or more of the total insurance payments. Insurance and patient billing is the lifeline of any medical practice and when compromised, you risk losing revenue quickly.

Comprehensive Revenue Solutions has the experience and the knowledge to help educate and correct Medicare compliance errors, as well as assist in creating a compliance plan to mitigate future risk.

Mandatory Medicare RAC audits began January 1, 2010.
Have you run a test and diagnosed any errors in compliance?
All providers who accept Medicare payments will be subject to audits. It is not a matter of "if" you will be contacted, but rather "when?" Since the start of the program in 2003, over $1 billion of improper Medicare payments have been identified, with 96% of these payments representing overpayments.

Now is the time to prepare a compliance plan review.
The Medicare RAC auditors are paid on a contingency basis. What this means is they are compensated to find errors. The auditors are looking at your coding and documentation, and checking for medical necessity. What you know is medical necessity for your patient could be interpreted differently by the RACs if your documentation is not what they want to see. Medicare will return every 45 days with more costly requests for additional charts and documentation until standards are met.

A third-party audit review prior to the RAC visit can pay for itself several times over. Even if you have your own internal audit process in place, an independent third-party review can give you increased confidence in your compliance. Any compliance errors you can catch and eliminate now help you to avoid possible repayments to Medicare later. We estimate that approximately 15% of providers also find coding or compliance errors in which they were underpaid and are able to file for reimbursement from Medicare.

How our HIPAA compliant, AAPC or AHIMA certified team of coders perform a Baseline Audit.
As part of our third-party compliance audit, we do a random selection assessment of your patient charts. Regardless if your specialty is cardiology, internal medicine, oncology, or another, your audit is assigned to a coder familiar with the needs of your billing and documentation. Once the audit passes the first level of review it is then assigned to a second level for quality control. Coders also have extensive practice in performing audits for government programs.

Within a week of completion, you are presented with a confidential, comprehensive report detailing the findings along with recommendations. Further educational webinars with a live instructor are available upon request.

For more information read our FAQ or contact us.