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Recovery Auditor

The Recovery Auditor, formerly known as the Recovery Audit Contractor (RAC), is a program that was created to identify overpayments/underpayments and to recover improper Medicare payments paid to healthcare providers under Fee-For-Service Medicare plans. Refer to section 302 of the Tax Relief and Health Care Act of 2006.

The program's mission is to identify and reduce Medicare improper payments through the efficient detection and collection of overpayments made on claims of health care services provided to Medicare beneficiaries, and the identification of underpayments to providers so that the CMS can implement actions that will prevent future improper payments in all 50 states.

The Noridian Supplier Contact Center can only answer general questions about the Recovery Auditor program. Medicare suppliers are advised to contact the Recovery Auditor directly with questions or comments concerning Recovery Auditor activities.

Topic Brief Description

How Does the Program Work?

Recovery Auditors review claims on a post payment basis. They identify specific issues they want to pursue, however are limited to claims approved through the CMS "new issue review" process.

Contact – HDI, CMS and Noridian

View contact information including website, address and email are provided

Types of Reviews

View the three types of Recovery Auditor reviews and the action suppliers should take.

Recovery Auditor Determinations - Agree or Disagree

Agree or disagree with the Recovery Auditor determination? Check out your options.

 

Last Updated Jun 22, 2016