Corporate Compliance

Tip: Consider the compliance department's role in your facility's RAC team

Compliance Monitor, November 3, 2010

If your facility has a robust compliance department, the recovery audit contractor (RAC) team may naturally fit within its structure. The RAC program and the compliance department share a common goal of detecting improper payments; therefore, the RAC team’s goals will align closely with those of the compliance department.

Additionally, the compliance department is familiar with making assessments for claims. Risk assessment is a routine pare of compliance department functions, and claims submission has been an identified risk in the OIG’s Compliance Program Guidance for Hospitals and the updated Supplemental Compliance Program Guidance for Hospitals. If the provider is considering a risk assessment related to RAC audit vulnerabilities, the compliance program can provide valuable expertise.

This week’s tip was adapted from The RAC Survival Guide: Successful Management of Recovery Audit Contractors. For more information about the book or to order your copy, visit the HCMarketplace.

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