Revenue Cycle

CMS updates RAC audit timeline: complex reviews still months away

Patient Access Weekly Advisor, June 3, 2009

CMS anticipates Recovery Audit Contractor (RAC) automated reviews will begin in late June and July, according to Marie Casey, deputy director of the Division of Recovery Audit Operations at CMS. However, this is not set in stone, she says, noting, "there is some leeway."

But complex reviews won't begin until later, says Casey. CMS is aiming to begin certain types of complex reviews (e.g., coding and DRG validation) this fall. However, medical necessity complex reviews won't begin until early 2010.

The nature of automated reviews is simpler on the whole, she says, making them an easier choice to roll out first. "The automated reviews are less burdensome on the provider, because there's no request for medical records," says Casey, adding that automated reviews are also easier on the RACs themselves to manage.

Read the full story by Andrea Kraynak of HealthLeaders Media.

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