Considerations for States

Finding Your Ideal RAC Partner

What are the qualifications of the ideal RAC partner? Only you can decide. In developing your RAC solution, be sure to look for a partner with proven experience in delivering mission-critical healthcare solutions to Medicaid Agencies that reduce costs, advance the quality of care, and promote public health.

Here are some things to consider as you search for the RAC partner that best suits your needs.

The ideal partner will be able to deliver a solution designed to support the identification, validation, audit, billing, and recovery of claims.

You should look for:

  • Accurate determinations
  • Effective provider outreach and education
  • Rapid implementation and exceptional results
  • Low rate of overturn for appealed claims
  • Minimal disruption or administrative burden on client staff and resources
  • Outstanding customer service
  • Experience working with Medicaid claims data and regulations

Key Indicators of an Effective RAC Partner

Here are five key indicators to consider when evaluating a vendor’s experience and capabilities to determining if they will serve as an effective partner:

  1. The right experience and credentials
  2. Effective strategies and processes to maximize recoveries
  3. Superior business application technology with full infrastructure management capabilities
  4. Effective client and provider communication
  5. Ability to deliver results