What is a key responsibility of the Medicare Recovery Audit Contractor?

The key responsibility of the Medicare Recovery Audit Contractor (RAC) is to conduct audits for improper coding. The primary objective of the RAC program is to identify and correct errors in Medicare claims, ensuring that providers are appropriately reimbursed for services rendered while preventing fraud, waste, and abuse in the Medicare system. This entails reviewing medical records and claims data to ensure that the billing codes accurately reflect the services provided to patients and comply with Medicare guidelines.

By focusing on improper coding, the RAC can help protect the integrity of the Medicare program and ensure that patients receive care that is appropriately billed. This role is crucial for maintaining the efficiency and effectiveness of healthcare payment systems. In contrast, conducting patient evaluations, providing patient care, or collecting outstanding payments do not fall within the RAC's responsibilities, which are strictly centered around auditing and compliance.