The North Carolina Medicaid Office of Compliance and Program Integrity has engaged Health Management Systems, Inc. (HMS) to conduct periodic audits of claims paid for services rendered to Medicaid members.
These audits are part of the Recovery Audit Program, established by the Centers for Medicare & Medicaid Services (CMS) and administered through Recovery Audit Contractors (RACs). The goal of the RAC program is to identify and recover improper payments made to Medicaid providers that do not meet state and federal requirements. RAC audits include:
- Coding validation
- Payment accuracy
- Compliance with state and federal regulations
- Adherence to policies and contractual obligations
This session will offer an overview of the program, available resources and key contacts to support providers throughout the audit process.
The webinar will cover the following topic areas:
- RAC Audit Process
- Medical Records Requests and Submission Process
- Provider Portal
- HMS Review Process and Criteria
- Types of Audits Performed
- Audit Determinations, Reconsiderations and Appeals
- Contact Information
Webinar Details
Date: Aug. 21, 2025
Time: 2 p.m. EST
Registration: https://events.teams.microsoft.com/event/f32ecbe1-e4de-4b30-9a00-9089c3680186@c663f89c-ef9b-418f-bd3d-41e46c0ce068
Please register using the link above.
Contact
HMS Provider Services Toll-free Number: 1-855-438-6415