RAC Audit Readiness
Prepare Before a Medicare Audit Puts Your Practice to the Test
A Recovery Audit Contractor (RAC) review can put your coding, documentation, medical necessity, billing practices, and Medicare reimbursement under scrutiny.
The best time to identify potential vulnerabilities is before an audit request arrives.
Peregrine Healthcare helps physician practices evaluate areas of potential RAC exposure, strengthen documentation and coding processes, and prepare teams to respond appropriately to Medicare audit activity.
What Is a RAC Audit?
The Medicare Fee-for-Service Recovery Audit Program is designed to identify and correct improper Medicare payments, including both overpayments and underpayments. RACs conduct post-payment reviews of Medicare Part A and Part B claims.
Reviews may be automated or require examination of the medical record and supporting documentation. CMS publishes approved RAC topics identifying the services, provider types, codes, and policies subject to review.
For medical practices, that makes accurate documentation, coding, billing, and internal processes especially important.
How Peregrine Helps You Prepare
RAC audit readiness starts with understanding where your practice may have exposure.
Depending on your specialty and areas of concern, Peregrine can review:
Coding Accuracy • Documentation Support • Medical Necessity • Modifier Usage • Billing Patterns • Claims Processes • Denial Trends • Medicare Requirements • Internal Workflows • Identified Areas of Risk
Our team helps identify potential vulnerabilities and provides practical recommendations, education, and corrective strategies where appropriate.
Explore Medical Billing, Coding & Compliance Audits →
Don’t Wait for an Audit Letter
Proactive auditing and monitoring can help identify billing and documentation issues before they become larger problems.
The HHS Office of Inspector General identifies internal monitoring and auditing as an important component of physician compliance efforts and recommends corrective action when deficiencies are identified.
Consider a RAC readiness review if your practice has:
- High Medicare Volume
- Complex Procedures
- New Service Lines
- Coding or Documentation Concerns
- Changing Billing Patterns
- Recurring Denials
- Previous Audit Activity
- Limited Internal Compliance Review
RAC Audit Readiness Assessment™
How Prepared Is Your Practice?
Take Peregrine’s complimentary RAC Audit Readiness Assessment™ to evaluate key areas of your practice’s audit preparedness and identify where additional attention may be needed.
Take the 5-Minute RAC Audit Readiness Assessment →
Why Peregrine?
Healthcare Experience Since 2001
Decades of experience across medical billing, coding, revenue cycle management, and healthcare operations.
Certified Coding Expertise
Our team includes AAPC-certified coding professionals with experience across complex medical specialties.
Revenue Cycle Perspective
We evaluate coding and documentation within the broader context of billing, reimbursement, denials, and revenue cycle performance.
Practical Next Steps
When potential vulnerabilities are identified, Peregrine provides clear findings and recommendations your team can act on.
Frequently Asked Questions
What does a RAC audit review?
Medicare RACs review claims to identify improper payments. Depending on the type of review, this may involve claims data or examination of medical records and supporting documentation.
Can we prepare for a RAC audit before receiving a request?
Yes. Practices can proactively review coding, documentation, billing processes, and areas associated with current Medicare audit risk. CMS publishes approved RAC review topics that practices can use to understand areas currently subject to RAC review.
What is an Additional Documentation Request (ADR)?
For a complex RAC review, the contractor may issue an Additional Documentation Request (ADR) requesting medical records and supporting documentation needed to review the claim.
Does Peregrine guarantee that we will pass a RAC audit?
No. No outside organization can guarantee the outcome of a Medicare audit. Peregrine helps practices identify potential vulnerabilities, improve readiness, and strengthen processes within our areas of expertise.
Know Your Risk Before an Audit Begins
Don’t wait for an audit request to discover weaknesses in your documentation, coding, or billing processes.
Or Talk With a Peregrine Healthcare Specialist
📲 877-463-1110
Based in Texas. Trusted by Physicians Nationwide Since 2001.