A RAC or commercial payer requests records for selected physician-office claims under audit. What is the appropriate response approach?
Select an answer to reveal the explanation.
Short Explanation
When a RAC or payer knocks, send the whole authenticated story on time—not a half-note, not a scrubbed version. Completeness and deadlines matter more than creative editing.
Full Explanation
External audit responses require timely submission of complete, authenticated medical records that substantiate the services and diagnoses billed. Omitting relevant pages, sending unsigned drafts, or missing deadlines increases denial and compliance risk. Practices should use a controlled process to gather, validate authentication, and track submission dates.