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TIP OF THE WEEK FOR PHYSICIANS FACING RAC OR MEDICAL AUDITS: CONSIDER SUGGESTING AN AUDIT OF 100% OF RECORDS

Recovery Audit Contractor (RAC) and private payer audits can be burdensome to physician practices. However, there are several things physicians can do to protect themselves before and during the audit process. Therefore, WhatleyKallas has compiled a "top ten" list of tips for physician practices facing RAC or other medical audits. We are highlighting one of these tips every week.  Click here for a link to the entire top ten list.

TIP SEVEN FOR PHYSICIANS FACING RAC OR MEDICAL AUDITS:  CONSIDER SUGGESTING AN AUDIT OF 100% OF RECORDS

If an auditor or payer is demanding repayment based on an extrapolation of a sample of a physician’s records and the physician believes there are other claims that have been underpaid, a physician should consider suggesting a 100% claims’ review.  Although this can be burdensome for both physicians and payers, it can prevent unfair extrapolation from a small, possibly unrepresentative claims’ sample, and can also help identify underpaid claims, thereby reducing the amount demanded, or, in some cases, eliminating the demand altogether.