RAC, MAC & UPIC Audits

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If your practice has ever received an audit letter—or you’re worried you might—this session is for you.

In today’s increasingly complex audit landscape, medical practices and healthcare providers are at higher risk of payer scrutiny than ever before.

Recovery Audit Contractors (RACs), Medicare Administrative Contractors (MACs), and Unified Program Integrity Contractors (UPICs) aren’t just acronyms, but real program integrity audit contractor programs that can seriously impact your revenue and reputation if you’re not prepared.

This webinar will walk you through what these specific types of audits are, why they happen, and how to navigate the audit process without panicking.

With real-world examples and a strategic roadmap, this session will help providers and compliance professionals shift from reactive to proactive when managing audits and mitigating potential risks.

Whether you’ve already received an audit letter or want to strengthen your readiness, this session will equip you with critical insights to defend your documentation, protect your revenue, and maintain compliance integrity.

Webinar Objectives

This dynamic webinar session is designed to help healthcare providers, practice administrators, and compliance professionals understand and navigate RAC, MAC, and UPIC audits with greater confidence and clarity.

Participants will gain practical knowledge of how these audits work, why practices are targeted, and what steps can be taken to prevent, prepare for, and respond to audit activity.

The session aims to demystify the audit process and equip attendees with real-world strategies to strengthen documentation, reduce risk, and maintain compliance under scrutiny.

Webinar Agenda

Understand what RAC, MAC, and UPIC audits are and what sets them apart
Recall the top compliance red flags that lead to RAC, MAC, and UPIC audits
Recognize ways to strengthen your documentation and billing practices to reduce compliance risk
Evaluate response strategies when you get an audit notice
Understand how to build an effective compliance program that keeps you audit ready

Webinar Highlights

Unpack what RAC, MAC, and UPIC auditors are really looking for
Discuss common services and billing practices that trigger RAC, MAC, and UPIC audits
Identify must-haves for clinical documentation and internal oversight
Discuss important audit details like timelines, communication tips, and what not to do
Outline the audit appeals process and how to challenge unfavorable audit findings
Discuss real-world audit cases and what was learned from these examples

Who Should Attend

Medical Coding Specialists
Medical Billing Specialists
Medical Auditing Specialists
Private Practice Physicians
Managed Care Professionals
Operations Leadership
Practice Administrators
Office Managers
Compliance Officers/Committees
Chief Medical Officer
Medical Practices
Accountable Care Organizations
Medical Societies
Medical Associations

Unpack what RAC, MAC, and UPIC auditors are really looking for
Discuss common services and billing practices that trigger RAC, MAC, and UPIC audits
Identify must-haves for clinical documentation and internal oversight
Discuss important audit details like timelines, communication tips, and what not to do
Outline the audit appeals process and how to challenge unfavorable audit findings
Discuss real-world audit cases and what was learned from these examples

Understand what RAC, MAC, and UPIC audits are and what sets them apart
Recall the top compliance red flags that lead to RAC, MAC, and UPIC audits
Recognize ways to strengthen your documentation and billing practices to reduce compliance risk
Evaluate response strategies when you get an audit notice
Understand how to build an effective compliance program that keeps you audit ready

Participants will gain practical knowledge of how these audits work, why practices are targeted, and what steps can be taken to prevent, prepare for, and respond to audit activity.

The session aims to demystify the audit process and equip attendees with real-world strategies to strengthen documentation, reduce risk, and maintain compliance under scrutiny.

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Presenter

Toni Elhoms, CCS, CPC, CPMA, CRC, CEMA

CCS, CPC, CPMA, CRC, CEMA, AHIMA-Approved ICD-10-CM/PCS Trainer

Toni Elhoms is an internationally known speaker and recognized subject matter expert on medical coding, reimbursement, compliance, and revenue cycle management. She is the Founder and CEO of Alpha Coding Experts, LLC (ACE). She holds multiple credentials with the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). Ms. Elhoms’ expertise extends to both inpatient and outpatient coding, compliance, billing, and reimbursement. Ms. Elhoms serves as ACE’s Senior Consultant and conducts training and educational seminars across the country on a variety of topics including, but not limited to, Medical Coding, Medical Billing, Practice Management, Managed Care, Revenue Cycle Management, Revenue Maximization, Regulatory Compliance, etc.