Kristin Walter

Q: How are Recovery Audit Contractors misunderstood? 

A: There are a lot of different Medicare contractors working out there, and it causes confusion. Often, there’s a tendency to paint recovery auditors with a bit of a broad brush. 

Q: Why are RAC auditors important to the skilled nursing industry? 

A: Congress put the RAC program in place to make sure Medicare claims are billed correctly. In addition to correcting overpayments, recovery contractors are looking for underpayments. Since the program began, they’ve sent $876 million in underpayments to providers. We hope skilled nursing facilities can come to see recovery auditors as partners.

Q: How can both groups create a better partnership?

A: I wish that there were less frustration with the process. Providers are providing excellent care to patients. But billing accuracy is important — Medicare is set to be insolvent within 10 to 15 years. 

Q: What should providers know?

A: Providers can make sure they develop a relationship with the folks that are auditing. Learn what contractor group they are from. There’s been so much attention to the RAC program, but not everyone is a RAC.