Do RACs look for underpayments? What happens if they find an underpaid claim?
Yes, Recovery Audit Contractors (RAC)s will identify underpayments as well as overpayments. In situations where a RAC identifies both overpayments and underpayments for a provider, the RACs offset the underpayment from the overpayment. In situations where a RAC identifies an underpayment for which there is no overpayment from which to offset, the RACs will inform the carrier or intermediary who will proceed with the claim adjustment and payment to the provider. A MLN Matters article, SE0617, was released on 04/10/2006 with additional information for providers concerning the identification of an underpayment by a RAC.
