A Recovery Auditing Contractor (RAC) performs what type of review using electronic methods?

The Recovery Auditing Contractor (RAC) primarily conducts an automated review, which involves utilizing electronic methods to analyze claims data. This process leverages software and algorithms to efficiently identify patterns, discrepancies, and potential overpayments within healthcare claims. Automated reviews are designed to streamline the auditing process, allowing for large volumes of claims to be evaluated quickly and accurately without the need for extensive manual intervention.

In this context, automated reviews are essential for maintaining efficiency within the healthcare payment system, ensuring that any inaccuracies can be flagged for further investigation. They serve as a first line of defense in detecting issues that may require more in-depth analysis.

While complex reviews, semi-automated reviews, and semi-complex reviews are valid types of audits, they typically involve varying degrees of human analysis and are not solely reliant on automated systems, which differentiates them from automated reviews.