We will look at your cases (pre-bill or post-bill) and validate the MS-DRG assignment with a Credentialed Coding Consultant (for coding), and a Credentialed Case Manager (for medical necessity). We can do it remotely, quickly, and accurately (within 72 hours of receipt).

All official coding guidelines and admission screening criteria will be cited for all recommendations with payment impact. If your records have been requested by the RAC, rationale for why we agree, or disagree, with your coding assignment and/or validation for appropriateness of the inpatient admission for a one day LOS, short stay, or 3 day SNF transfer cases, will be provided. This may be used for the discussion period to justify your MS-DRG assignment and codes, and medical necessity billed.

We will provide a comprehensive assessment that supports the recommendation, or outlines recommendations for improvement.

Register Now for your records review or Click Here for more information.

• Log, track, reconcile and report all aspects of an audit.
  
  
• Manage ALL types of audits & denials, including RAC, internal audits, retrospective data quality reviews, compliance, privacy, etc.
  
  
• Scan and electronically store all audit correspondence and records for easy viewing.
  
  
• Assign cases and projects to anyone in your organization.
  
  
• Track and reconcile all other types of external reviews coming from third party payors and governmental regulatory agencies by denial codes.
  
  
• Create customized data fields for data collection and reporting.
  
  
• Receive email and on-screen alerts to keep you on track!

Understand, manage and reduce your improper payment risk from the RACs. Identify specific accounts and areas for attention long before your demand letters arrive. Incorporate RACauditor.com’s data mining program into your organizations process improvement initiatives today!

Our timely data mining reports can:

• Identify likely coding and reimbursement compliance and recoupment exposure;

• Be run for the entire look-back period;

• Support continuous improvement initiatives if run routinely;

• Be a vital component in your process improvement program;

• Be used to report and measure progress through key metrics and benchmarks;

• Provide RAC risk specific to your high volume MS-DRG;

• Break-down your Top MS-DRGs targeted for improper payment due to:

  • Medical necessity

  • Coding

  • RAC risk based on Complex Review overpayment and case volume
    
    
• Identify outpatient risk areas and much more

Register Now! to get your free customized RAC Scorecard Assessment, an estimate of the general level of improper payment risk associated with the RAC program based on the CMS data sources.

Mock RAC appeals response
This service will familiarize the client with requirements of the RAC appeal process and an understanding on how to maximize the appeal opportunity.

RAC Appeal Education
Our education services help you to take control of the RAC process… from deciding which claims to appeal and how to respond to recoupment letters.

RAC Appeal Outsourcing
RACAuditor provides complete RAC appeal outsourcing services, including: case selection, documentation review, response preparation and ALJ appeals.