RAC Review Management (Medi-Cal)

The Recovery Audit Program is a government review system designed to correct Medicare claims payments, stop Medicare abuse, and encourage accurate Medicare claims filing. To carry out the process, the government hires Recovery Audit Contractors (RACs) that analyze claims and determine whether a provider was paid too much or too little by Medicare for a patient service.

  • Explain what RAC reviews are and why they were created
  • Describe the process of a RAC review
  • Name the different levels of RAC appeals
  • List methods of preventing and handling RAC reviews

Additional Information

Advance Preparation: None

Prerequisites: None

Program level: Basic

Delivery Method: Self-study

CPE Field of Study: Specialized Knowledge


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