RACs are auditing practices. Learn how to prepare.
The RAC Toolkit for Physician Practices is your practice's answer to turning plans into proactive action for success during Recovery Audit reviews.
Authors Elizabeth Lamkin, MHA, and Amanda Berglund, MS, MBA, describe how to establish and sustain an effective RAC-preparedness structure that can be adapted to fit any organization's system. They provide best practices for successful processes and outline each staff member's role in your RAC audit program.
Physician practice settings are getting audited by RACs. Whether you are responding to a Recovery Auditor or another government auditor, your program must operate as effectively as possible. You will use their tested, proven, and practical tools that will help you build a more effective billing compliance program. You'll learn how to bring finance, business office and clinical staff together for operational improvements that directly affect your bottom line.
The RAC Toolkit for Physician Practices help you achieve the following goals:
- Take a systemic approach to RAC compliance
- Incorporate effective structure and processes to existing systems for measurable results
- Organize committees and facilitate information flow
- Appeal effectively and within deadlines
- Use proven tools and methods for an effective RAC program
Table of Contents
About the Authors
Introduction
Chapter 1: RAC Overview
Chapter 2: Preparing for RAC
Chapter 3: The Right Structure Organizing the Right Committees
Chapter 4: Critical RAC Roles: Stakeholders and Roles for Prevention of Billing Errors
Chapter 5: Automated Reviews
Chapter 6: Complex and Semi-Automated Reviews and Extrapolation
Chapter 7: The Appeal
List of Acronyms
Among the tools you can download are:
- RAC appeal timeline
- RAC preparedness checklist
- RAC committee structure flowchart
- Organizational chart for RAC-related personnel
- Sample RAC committee meeting agenda
- Complex case review worksheet
- Automated review timeline
- Complex review timeline
- CMS form 20027
- CMS form 20034
- CMS form DAB101
- CMS form 20033
Who should read The RAC Toolkit for Physician Practices?
Coding supervisors, billing supervisors, practice administrators, practice managers, office managers, RAC coordinators, administrator coding/compliance auditors, compliance officers, compliance coordinators, coding supervisors, and coding specialists.