MES Certification Navigator
PI9

CMS-Required Outcome

CMS-required outcome

System can support activities conducted by Medicaid RACs can including review all claims submitted by providers of items or services for which payment has been made to identify underpayments and overpayments and recoup overpayments as necessary.

Default metrics
  • Provide a copy of the RAC report of total claims submitted, underpayments, ovrpayments and recoup overpayments
Regulatory sources
  • None cited

Other Program Integrity outcomes