Business > CASE STUDY > Week 8 TD Purpose of Recovery Audit Contractor.docx Week 8 Purpose of Recovery Audit C (All)

Week 8 TD Purpose of Recovery Audit Contractor.docx Week 8 Purpose of Recovery Audit C

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Week 8 TD Purpose of Recovery Audit Contractor.docx Week 8 Purpose of Recovery Audit Contractor Explain the history and purpose of the Recovery Audit Contractor (RAC) demonstration project, as we... ll as the process of the RAC as it pertains to its impact on healthcare organizations. Recovery Audit Contractor Demonstration Project Recovery Audit Contractors (RAC) is the term used by the Centers for Medicare and Medicaid (CMS) program that is responsible for detecting and correcting improper Medicare payments (Harrington, 2020, p. 241). CMS (2019) explains that examples of improper payments include excluded providers, unauthorized prescribers, and improper refills on DEA scheduled drugs. The RAC demonstration project uses real auditors (Recovery Auditors) to go into the health care setting and look for overpayments and underpayments as well as help to identify future improper payments to lower the overall error rate for processing Medicare claims (Harrington, 2020, p. 241-242). Harrington (2020) goes onto explain that CMS conducts as many demonstration projects as needed to evaluate the program and make any chnages that might be necessary (p. 242). Lastly, the RAC demonstration project is one that assesses the effective of a service offered by CMS and is defined by the methods of service delivery, coverage of new types of service, and new payment approaches on beneficiaries, providers, health plans, states, and the Medicare Trust Funds (Harrington, 2020, p. 242). Evaluation projects are also done. Harrington (2020) expla. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. .. . . . . . . . . . . . . . . . . . .. . . . . [Show More]

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