Centers for Medicare & Medicaid Services (CMS) Recovery Audit Contractor (RACs) conduct automated reviews of Medicare payments to health care providers—using computer software to detect improper payments. RACs also conduct complex reviews of provider payments—using human review of medical records and other medical documentation to identify improper payments to providers. Improper payments include:
- incorrect payment amounts;
- incorrectly coded services (including Medicare Severity diagnosis-related group (MS-DRG) miscoding;
- non-covered services (including services that are not reasonable and necessary);
- duplicate services.
AHA created RACTrac—a free, web-based survey—in response to a lack of data provided by CMS on the impact of the RAC program on America's hospitals. Hospitals use AHA’s online survey application, RACTrac, to submit their data regarding the impact of the RAC program. Survey questions are designed to collect cumulative RAC experience data, from the inception of a hospital’s RAC activity through the 4th quarter of 2010. Survey registration information and RACTrac support can be accessed at firstname.lastname@example.org 1-888-722-8712.
For more information about Recovery Audit Contractor, contact a knowledgebroker.