• E-mail
• Print
• RSS

Take note: 10 RAC facts to consider

Patient Financial Services Weekly Advisor, January 30, 2009

Consider the following 10 RAC facts:

• RAC must send only one review result per claim (e.g., coding and medical necessity review must be in same letter)  
• RAC must report potential fraud immediately  
• RAC must report potential quality issues  
• RAC may receive “tips” from CMS, affiliated contractors, Office of Inspector General, law enforcement or other agencies  
• Recoupment is through current or future Medicare payments  
• Provider can repay through installment plans up to 12 months, or longer with approval  
• Debtor (e.g., hospital or healthcare provider) can present RAC with settlement offer
• RACs will receive smaller fee if providers voluntarily self-report after receiving a medical record request or demand letter  
• RAC must provide a toll-free customer service number to all providers  
• RAC shall provide the CMS project office with all correspondence containing complaints

Editor’s note: These facts were provided by Linda M. Fotheringill, Esq., of Washington & West, LLC, in Baltimore, MD, during the January 6 HCPro, Inc., audio conference, “RAC Readiness: Develop an Effective Audit Tracking System.” Learn more about the audio conference.

• Comment
• E-mail to a Colleague
• Print
• RSS
• Archive

Comments