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Question: Imagine that you are a member of the quality assurance staff at a local hospital. You have been asked to provide an update to the medical coders on the current trends pertaining to recovery audit contractor (RAC) issues. This Assignment also examines the National RAC Program and inspector general policies and procedures for monitoring compliance at the local hospital. The summation needs to demonstrate understanding of the RAC policies and present a logical solution for assuring compliance.
Your report needs to include the following:
definition of the problem analysis of the problem assessment of potential solutions a logical solution to the problem
Perform a search on health insurance policies.
Perform a search on RAC (recovery audit contractor) audits. Assess the purpose of the RAC audits. Determine the specific information for state of Ohio Analyze the kind of information on the amount of money collected (most recent data available). As a medical coder, explain your role in assuring the accuracy of data and the prevention of an RAC audit. Can it be prevented? Design a table or graph depicting information you have obtained regarding your state or federal program. Assess if the RAC has been successful or failing in assuring correct payments. Conduct a search on the Internet for presenting possible RAC issues. Demonstrate critical thinking by developing a summation by analyzing the RAC facts. Viable solution/approach is needed for assuring compliance. The Medicare/Medicaid and AHIMA websites are good places to start.
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