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: