Revenue Cycle

Providers report first RAC denials in Florida, South Carolina

Recovery Auditor Report, November 25, 2009

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Healthcare providers in several states received their first RAC denials. And Connolly Healthcare, the Region C RAC for Florida, South Carolina and several other states, has been behind many of them.
 
One hospital in South Carolina reports having three claims denied. However, the way in which it learned of the denials did not go smoothly. The hospital received a call in late October from Connolly regarding a denial letter the hospital never received. The RAC sent the original denial letter in early August, and although it was addressed to the hospital, it apparently had no specific contact person listed, and the appropriate people/team at the hospital never received it. 

The hospital had provided Connolly with the name of the contact person for their facility months prior via the form Connolly provided on its Web site, according to a hospital employee.

“Connolly acknowledged that the absence of a contact person on the letter was their error and they are working to correct it,” she said.

 In the meantime, the RAC has faxed a copy of the denial letter to the hospital. The total take back was less than $200, but it has given the hospital a chance to test its RAC tracking system, which is reportedly working well thus far.

Another small contract rehab company that contracts with facilities across seven states, mainly in the southeast, also reported seeing RAC denials. Three of its facilities—all skilled nursing facilities, averaging 120 beds—have now received demand letters, according to the Florida-based provider. 

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