During a RAC audit, what options does a provider have if they agree with the demand letter?

When a provider receives a demand letter during a Recovery Audit Contractor (RAC) audit and agrees with its contents, the most logical course of action is to pay the demand or request a payment plan. This option allows the provider to address the overpayment directly and ensure compliance with the audit findings.

Agreeing with the demand letter indicates that the provider acknowledges the overpayment identified by the RAC. By paying the demanded amount, the provider resolves the issue efficiently, thereby preventing further legal or administrative complications. If the provider faces financial constraints that make immediate payment challenging, requesting a payment plan is a prudent alternative. This flexibility helps manage the financial impact while staying in compliance with audit requirements.

Other options, such as submitting a complaint to CMS, filing an internal report, or discontinuing claim submissions, do not address the immediate need to resolve the overpayment highlighted in the demand letter. Selecting the payment option minimizes potential penalties and interest that could accrue if the payment is delayed. It also helps maintain the provider's good standing with payer contracts and avoids disruptions in future claim submissions.