In order to help ensure that the outcomes of RAC audits are as accurate as possible, CMS requires all Recovery Audit Contractors to employ personnel to conduct RAC audits who are expected to be experts in various facets of the Medicare billing system and Medicare's clinical payment criteria. This includes certified coders, nurses, therapists, and a physician contractor medical director (CMD).
Unfortunately, mistakes during the RAC process remain common, and providers frequently find themselves forced to challenge flawed liability determinations.