Matchinski Jayme R
Partner, Hinshaw & Culbertson LLP, Chicago, IL, USA.
J Med Pract Manage. 2010 Sep-Oct;26(2):76-9.
The Recovery Audit Contractor (RAC) Program has become permanent by statute, and RACs have expanded their focus and efforts to identify improper Medicare payments in all 50 states. Physicians and practice groups that bill Medicare Parts A and B may be subject to a RAC Audit. There are two types of RAC reviews and audits, and there are five levels of appeals available to providers when Medicare claims are denied or a RAC audit identifies a previous Medicare overpayment. Physicians and practice groups should take steps to ensure compliance with Medicare regulations and to be prepared prior to receiving a letter from a RAC.
回收审计承包商（RAC）计划已通过法规成为永久性计划，RAC已扩大其关注重点和工作力度，以识别全美50个州中不当的医疗保险支付情况。向医疗保险A部分和B部分计费的医生和医疗机构可能会接受RAC审计。RAC有两种审查和审计类型，当医疗保险索赔被拒或RAC审计发现之前存在医疗保险多付款项时，医疗机构有五级申诉途径。医生和医疗机构应采取措施确保遵守医疗保险规定，并在收到RAC来信之前做好准备。
