Which program is described as a network of individuals who identify Medicare underpayments and overpayments?

Which program is described as a network of individuals who identify Medicare underpayments and overpayments?

• A. HIPPA
• B. Informatics
• C. Medicare Recovery Audit Contractor Program
• D. Durable Medical Equipment

Answer: (C)

This describes a program that uses a nationwide network of Recovery Audit Contractors who review Medicare claims after payment to identify improper payments and recover funds, helping to correct billing errors and improve payment accuracy. Contractors target high-risk areas, perform post-payment audits, and recoup overpayments while flagging potential underpayments for correction. This setup is designed to reduce waste and fraud by ensuring that Medicare pays only what’s correct. HIPAA is about protecting privacy and security of health information, not auditing payments. Informatics refers broadly to handling and analyzing health data, not a specific Medicare audit program. Durable Medical Equipment is a category of medical equipment, not a payment-audit network.

This describes a program that uses a nationwide network of Recovery Audit Contractors who review Medicare claims after payment to identify improper payments and recover funds, helping to correct billing errors and improve payment accuracy. Contractors target high-risk areas, perform post-payment audits, and recoup overpayments while flagging potential underpayments for correction. This setup is designed to reduce waste and fraud by ensuring that Medicare pays only what’s correct.

HIPAA is about protecting privacy and security of health information, not auditing payments. Informatics refers broadly to handling and analyzing health data, not a specific Medicare audit program. Durable Medical Equipment is a category of medical equipment, not a payment-audit network.