Welcome to your monthly survival guide for Medicare's recovery audit contractor (RAC) program. We're glad to have you on board and look forward to helping you prepare for, manage and cope with RAC throughout the coming year. As a RAC consultant in the state of California and a leading release-of-information service provider, our two companies have been heavily involved with RAC since the first record request was received and the first audit was conducted nearly 4 years ago. A lot has changed and a lot of lessons have been learned.

With RAC, the burden falls on each facility to protect reimbursement dollars and stay ahead. Our column can help. Over the next 12 months, we'll explore important RAC topics such as:

• The Three Steps to RAC Preparedness
• Managing RAC Demands: Human and Technological
• Improving Clinical Documentation for RAC
• Compliance and Winning Physician Cooperation
• The Who, What and When of Appeals
• Deciding if an Appeal is Worth the Work

In each column we look forward to sharing our knowledge with you-the health information professional. We invite you to visit our column every month and uncover the know-how, skills and techniques you need to help your organization thrive under RAC. Let's begin with a brief overview of the RAC program.

Brief History and Impact on Providers
Medicare's RAC program started in 2005 as a demonstration project in five states: California, New York, Florida, South Carolina and Massachusetts. During the demonstration project, Medicare recouped nearly $1 billion from provider organizations. The permanent program will be rolled out to all 50 states over the next 12 months with nearly 20 states scheduled to begin receiving RAC requests soon. And although the program is temporarily on hold, we expect Medicare to move quickly during the first quarter of 2009 with complete roll out of the permanent RAC program nationwide by Jan. 1, 2010.

Medicare's initial goal with the RAC program was to detect and correct improper payments in the Medicare fee-for-service program. Predicted by some to reach bankruptcy in less than 10 years, Medicare is relying on funds received from RAC recoupment to keep Medicare solvent. Particularly as more and more baby boomers will be taxing the Medicare system in the coming years.

An Opportunity for HIM to Shine
For HIM professionals, RAC presents a new opportunity to elevate awareness about our profession, demonstrate our effectiveness and provide exemplary leadership within our organizations. According to a recent survey conducted by Wolters Kouwer Health, 92 percent of HIM directors are already familiar with RAC. That's the good news. The bad news is that the majority (88 percent) either anticipate a negative financial impact or a break-even scenario.¹

HIM's involvement in RAC is a key factor in an organization's success under the program. Our profession has the knowledge, skills and holistic understanding of coding and billing to help minimize RAC disruption, protect reimbursement dollars and ensure the process stays on track. In fact, many HIM departments are already working on RAC preparedness with internal audits, document improvement programs and RAC committees.

For HIM professionals at all levels, RAC can be the next step in your career ladder and an excellent way to elevate your role within your organization. Visit our column next month as we dive into the three steps of RAC preparedness: forming a successful committee, identifying your risk and managing your process.