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RAC Audits Now a Potential Risk for Physicians

James Carroll, for HealthLeaders Media, March 12, 2010

In addition, physicians fall under Part B billing, and RACs receive 50% of the agreed upon contingency percentage for recovery efforts accomplished through the offset process of Part B claims, as opposed to 75% for Part A claims, according to Blue. However, despite the fact that physician audits will result in lower recoupment amounts, RACs can still target anywhere where there are problems, and physicians should be aware.

"It's something that's always in the back of a physician's mind, but at this point I'm not sure how it will immediately affect anything."

With that in mind, physicians should take the same preventive measures that facilities take against RACs. By making sure the billing is clean, the documentation is in order, and that the bill matches the documentation, this strategy should benefit physicians and prevent audits.


James Carroll is associate editor for the HCPro Revenue Cycle Institute.

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