CMS RAC Base Line Audit Service FAQs
What is the CMS RAC Audit and how does it affect me?
Medicare has contracted for 2009 and beyond to audit every provider in the nation and Puerto Rico who files with Medicare. It is expected
to be fully in place by 2010 in all 50 states and Puerto Rico on a permanent basis. The purpose is to
identify incorrectly billed claims that are overcharging Medicare. Based on findings, if compliance to Medicare billing rules is not up to
standard, penalties may be assessed including fines and in severe cases, the loss of Medicare billing priveleges.
What is the benefit of doing a Base Line Audit?
The Base Line Audit will determine a provider's compliance with the CMS rules at the time of the audit. The Base Line Audit will prepare the physician
for any internal changes to documentation or coding he/she may need to make.
Why would I want a third party to conduct this audit, why not just wait for Medicare to do their audit?
Medicare does not provide any guidance to the physician or provider of care outside of giving them written guidelines. Most providers won't take the time to review those.
The RAC companies or contracts are paid on a contingency based fee, so they have incentive to find incorrectly paid claims. Our Base Line Audit will help the provider
indentify areas of deficiencies and correct those prior to the RAC audit.
How does your audit service work?
Once we receive payment, we will provide you with a list of the 5 office visit codes we pull files from. Your office staff can fax the information requested to our
secure HIPAA compliant fax line. Our auditors will analyze the files and generate a report within approximately 1 week. We will then contact you and set
a time to go over the report with you and consult with you as to any corrections that may need to be made.
For more information, contact us here
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