Jacobus Consulting
RAC Services
Jacobus is uniquely qualified to help healthcare providers reduce their RAC exposure. We bring deep Revenue Cycle and clinical knowledge, proven denials and underpayment process expertise, pre-built databases and tracking tools, successful educational methods, and complete project management to deliver a complete RAC solution.
CMS utilizes selected Recovery Audit Contractors (RAC) to audit and recover provider overpayments. The RAC audits operate under strict guidelines, with well defined steps, timelines, and guidelines for provider appeal of payment recovery. The RAC project began as a demonstration effort, but now will encompass all 50 states by 2010.
To avoid significant financial penalty, it is imperative to be prepared for RAC audits and take action now to establish governance and roles, define clear and consistent policies and processes, fine tune the supporting tools for automation of those processes, and establish multidisciplinary RAC teams at their facilities.
There is no “one size fits all” approach to RAC preparedness and no single “product” solution. RAC preparedness touches many aspects of the Revenue Cycle – including clinical documentation and review, health information and coding, billing, denials and underpayment management - as well as successful use of technology for automation, tracking and control. A good solution must include a proven approach and yet still fit the unique situation of each provider.
Jacobus RAC related services include
- RAC Preparedness Assessment.
- RAC Planning and Strategy Development - including staffing and productivity impact, and integration of RAC processes with related Revenue Cycle, Compliance and Risk Management initiatives.
- RAC Governance – establishment of RAC Liaisons and multidisciplinary teams with training on roles and responsibilities, and establishment of team action plans.
- RAC Process Optimization, Policy and Procedures – optimization of P&P’s and processes to include documentation review, coding, claim review and demand appeal processes, and also development of aggressive underpayment appeal processes.
- Implementation of overall document management and database logging and tracking tools for visibility and control.
- Education of all team participants, including complete training and documentation.
