Recovery Audit Contractor (RAC) Edits

OCExaminer's analyzes both your inpatient and outpatient claims to help you identify any claims that contain potential RAC issues. These alerts can be used to determine possible claim errors on the front end, allowing any necessary corrections to be made before the claims are processed. Some current RAC Alerts covered in this module are:

• POA / HAC
• Units of blood administration
• High-risk one-day stays
• Wound care / debridement

Alerts are added and/or modified as issues are published.