When it comes to preparing for RAC audits, timing is everything.  A common misconception among physicians is that once the RACs begin auditing doctors, there will be time enough to prepare then.

There are probably several reasons for this kind of thinking, but two that stand out will be addressed in today’s article.

First, nobody wants to be the first among his peers to get serious about RAC.  After all, only hospitals are being audited right now.  Getting all hot and bothered about RAC might seem reminiscent of some of the Y2K doomsday predictions in the late 1990s.  Nobody wants to be seen as over-reacting.

A second reason is that most physicians don’t yet understand the look-back period.  RAC can only go back 3 years, but not earlier than October 1, 2007.

Perhaps you’re thinking “what’s so great about that?”

Let’s say Doctor A got a baseline audit in late 2009 – think AAPC certified coder, your specialty, auditing exactly the way RACs do.  He then used this information to get into compliance by the first of 2010.

Doctor A would have only 27 months of non-compliant exposure – October 1, 2007 to January 1, 2010.

His golfing buddy – Doctor B – procrastinates.  Let’s say he keeps procrastinating until after October 1, 2010.   Doctor B will have a full 36 months of exposure.  Who gets the last laugh?

Nobody knows when RACs will focus on physicians.  We actually heard a rumor that it will be two years before Connolly gets to physicians.  Certainly Connolly hasn’t announced that!

But what if physician audits didn’t get rolling for another two years?    Doctor A would then have only 12 months of exposure.  Doctor B would have about twice the exposure.

QUESTION:  Are you more like Doctor A or Doctor B?   Why wait?   If you’re Doctor A, click HERE for more information.   (Doctor B?   Your Tee Time is at 2 – don’t be late!)


Winston Creath is an independent executive healthcare consultant working in the compliance and revenue cycle management arenas on behalf of physicians and clinics. He serves as President of National Business Solutions of GA, LLC. He can be reached at winston@nbsoga.com for questions or comments.

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