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RAC Management functions

We carefully studied the requirements of the RAC program from the provider’s perspective, and developed RAC Management to address the most critical needs with one solution:

Identify exposure

  • Allow providers to analyze historical data to assess financial risk in preparation for a RAC audit
  • Provide pre-selected report criteria based on known RAC targets
  • Provide pre-defined reporting

Prevent new problems

  • Provide claim edits specific to known RAC audit targets through MedicareRT
  • Warn billers, allow review prior to submission
  • Trend claims by RAC edits

Manage the audit

  • Track medical record request deadlines and RAC acknowledgement with minimum data entry
  • Alert to impending deadlines, monitor backlog
  • Identify and track automated audit take backs

Manage appeals

  • Track claims through the audit, appeal and/or re-bill process
  • Alert to impending deadlines
  • Report on the outcomes of the appeal process

Identify root causes & impact

  • Identify and track automated audit take backs
  • Alert to impending deadlines, monitor backlog
  • Monitor outcomes, predict trends
  • Calculate net financial impact
  • Indicate percentage appealed, overturned
  • Reveal root causes & impact

"I looked at a couple other vendors, CareMedic just rose to the top because they have a very robust product. A lot of the competition frankly had what was almost more of a contract management sytem."

-George DerBedrosian
Administrative Director, PFS
Alta Bates Summit Medical Center