American Health Information Management Association (AHIMA) Certification Practice Exam

How much money did the RAC demonstration uncover in improper payments?

1. Hundreds of dollars.

2. Thousands of dollars.

3. Millions of dollars.

4. Billions of dollars.

The correct answer is: Billions of dollars.

The Recovery Audit Contractor (RAC) demonstration uncovered billions of dollars in improper payments. The RAC program was initiated to identify and recover improper Medicare payments, which often arise from issues such as billing errors, incorrect coding, or fraud. The scale of the improper payments identified through this initiative indicates significant vulnerabilities in the healthcare reimbursement system. The figure in the billions reflects not only the extensive financial impact but also highlights the importance of compliance and diligent oversight in healthcare billing practices. It emphasizes the need for healthcare organizations to implement robust internal controls and auditing processes to mitigate the risk of such improper payments in the future. The substantial amount discovered serves as a call to action for improvement in claims submission practices across the healthcare industry to safeguard against financial losses due to inaccuracies and fraud.