There are many factors to consider when evaluating the need for a RAC coordinator. Primary to the decision is the actual volume of requests and dollar amount of revenue at risk. Larger organizations or those with multiple campus units and tax ID numbers should assign a full-time coordinator. The exhibit below provides some general guidelines.

AHIMA provides strong guidance and has outlined attributes, duties, roles, and responsibilities of the RAC coordinator in its RAC toolkit (www.ahima.org). These include general oversight of all RAC functions, tracking status of all activity using an automated tracking system, and open communication with all RAC team members. Additionally, AHIMA recommends the RAC coordinator be responsible for analyzing and auditing RAC findings and preparing ongoing reports for executive leadership. These reports will subsequently be used as input for financial risk assessments and also as new revenue recovery audits are introduced.

Indicators of the Need for a RAC Coordinator

                                                              Full-Time                           Part-Time
                                                             Coordinator                      Coordinator

Single Tax ID / Campus Units                                                               X
Multiple Tax IDs / Campus Units                 X 
High Financial Risk                                    X 
Low Financial Risk                                                                               X
CDI Program Already in Place                                                               X
No CDI Program in Place                            X 

Note: CMS defines a campus unit as one or more separate facilities/practices operating under a single Tax ID Number (TIN) and physically located within zip codes with the same first three digits. For more information, visit www.cms.hhs.gov/RAC/Downloads/DRGvalidationADRlimitforFY2010.pdf.

 

Publication Date: Friday, January 01, 2010

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