Health Information Management

Topic: CMS announces permanent RACs, increases estimate of appeals

HIM Connection, October 14, 2008

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In an October 6 press release, CMS announced the following permanent national recovery audit contractors (RAC):

  • Diversified Collection Services, Inc. of Livermore, CA: Region A, initially working in Maine, New Hampshire, Vermont, Massachusetts, Rhode Island and New York  
  • CGI Technologies and Solutions, Inc. of Fairfax, VA: Region B, initially working in Michigan, Indiana and Minnesota
  • Connolly Consulting Associates, Inc. of Wilton, CT: Region C, initially working in South Carolina, Florida, Colorado and New Mexico
  • HealthDataInsights, Inc. of Las Vegas: Region D, initially working in Montana, Wyoming, North Dakota, South Dakota, Utah and Arizona  

Click here to view a RAC expansion schedule and timeline for each of the above regions.

CMS also noted in its press release the publication of its July 2008 report on the three-year demonstration program. The update includes revised appeals data for denied claims through June 30 and actually reveals a higher appeals rate (19.6% versus 14%) and a higher overturn rate in favor of providers for appealed denials (35% versus 33%) than its initial report. Click here to view the report.

To sign up for HCPro's October 28 audio conference, "RAC Appeals: How to Successfully Manage the Process," visit http://www.hcmarketplace.com/prod-6918.html.



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