RAC Frequently Asked Questions

1. Is RAC a new issue facing the healthcare industry?
2. What were the biggest challenges confronting medical facilitates participating in the 3-year RAC demonstration program?
3. What was the biggest obstacle that confronted RAC providers during the demonstration program?
4. What was the most difficult area to target for participating medical facilities?
5. Does CMS offer documentation that pinpoints what caused the worst RAC issues for organizations participating in the demonstration program?
6. Was the RAC demonstration initiative random?
7. On average, how may RAC reviews uncover an improper payment finding?
8. How important is day-to-day coding when it comes to the RAC demonstration?
9. Did facilities participating in the RAC demonstration follow CMS’s instructions on extrapolation methodology for internal findings?
10. Will extrapolation eliminate the RAC process for organizations?
11. Did RAC focus on one type of medical facility over another (i.e. profit or not-for-profit, teaching or non-teaching hospital, urban or suburban facility, acute care or long-term critical access?
12. Were states that had less CMS beneficiaries reviewed differently?
13. Whom should a medical facility appoint as gatekeeper for the RAC process?
14. Will RAC use certified coders and medical directors in the national program?
15. When will CMS start distributing the RAC letters?