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Pursuant to 42 U.S.C. § 1395ddd and the RAC Assertion of Work, RACs are prohibited from deciding on claims at random to overview. As a substitute, RACs use proprietary data evaluation methods” to determine claims likely to comprise overpayments, a process often known as focused overview.” A result of RACs participating in these targeted reviews” is that sure kinds of claims and sure supplier types may even see extra RAC auditing activity than others. Related Post: this guy For example, in the course of the RAC demonstration program, eighty five % of the alleged overpayments recognized and collected arose from inpatient hospital claims; 4 percent arose from outpatient hospital claims; and the remaining eleven p.c arose from inpatient rehabilitation facility claims, expert nursing facility claims, physician claims, durable medical tools claims, and other varieties of claims.