Title: Recovery Audit Contractor (RAC) Audits

Presenter: Betty A. Hovey, BSHAM, CPC, COC, CPC-I, CPC-P, CPMA, CEMC, CCS-P, CDIP, Senior Consultant and Owner of Compliant Health Care Solutions

Time: 56:01

Description: Recovery Audit Contractors (RACs) detect and correct past improper payments in the Medicare FFS program. Betty A. Hovey describes the RAC review process, including how to respond to an additional documentation request, and shares resources to find the RAC that covers your region.

Objectives:

1. Define Recovery Audit Contractors (RACs).
2. Understand how the RACs operate.
3. Follow steps to address an additional documentation request (ADR).

Key Topics:

• Recovery Audit Contractors
  o Definition
  o Map
• How Do the RACs Operate?
  o Complex Reviews
  o Complex Review Process
  o Automated and Semi-Automated Reviews
  o Topics for RAC Review
  o Performant Sample Documents
  o ADR Submission Instructions
  o Sample Documents
  o FAQs
  o Limits to ADRs
  o Examples
• Steps to Addressing an ADR
• Final Thoughts
  

Compliant Health Care Solutions

Betty is a nationally recognized health care consultant and speaker. She is an expert auditor and loves to help practices stay compliant and profitable. Betty's philosophy is, "Physicians work hard for their patients and they should be paid properly for what they do."

Betty brings over thirty years of healthcare experience. She has worked for practices both large and small with the same intensity and attention. She has spent years on the "front lines" for practices handling medical billing, coding, claims, and denials.  She has also managed practices and directed health care system departments. Her areas of specialization include Evaluation and Management, Primary Care, Dermatology, Plastic Surgery, Cardiology, Cardiothoracic Surgery, General Surgery, GI, E/M and procedural auditing, and ICD-10-CM.

Compliant Health Care Solutions is a consulting firm that provides compliant solutions to issues for all types of health care entities: solo practices, physician groups, physician offices, health care systems, care facilities, and payors.

https://chcs.consulting/