Scrubs & Suits: The Connection: OIG, RAC & You

You might have wondered what is the connect between the Office of the Inspector General (OIG), Recovery Audit Contractor (RAC), and my health care career? AAPC National Advisory Board member Lillie Washington, BSN, RN, MSM, CPC, CMSCS recently discussed the relationship between the three in an article for Scrubs & Suits.

““Improper payments” is used to refer collectively to underpayments and overpayments.  Situations where the provider submits a claim containing an incorrect code but the mistake does not change the payment amount are not considered to be improper payments,” she wrote. “[L]et’s review suggested actions you can take to be proactive in detecting and deterring waste, fraud and abuse:

Commit to ethical professional conduct;

Stay abreast of current legislation to avoid submitting claims that do not comply;

Don’t be afraid to ask questions;

Review OIG reports and RAC findings to identify what improper payments have been found and identify areas of risk; and

Avoid compliance issues before they arise by developing and implementing an effective compliance program.”

Read the full article here.

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