CMS releases 16 new, updated RAC FAQ
Recovery Auditor Report, January 7, 2010
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CMS released several new and updated FAQ on its Web site in December. The questions are as follows:
- If a provider performs a self audit how should they notify the RAC?
- How will the RAC choose the health care entity that is to be reviewed for over-payments or underpayments? Will it be a random process?
- Will the RAC appeal process mirror the regular Medicare appeal process?
- How is the RAC paid for finding and recovering overpayments?
- Will the timing for appeals by the Medicare contractors be the same for the RAC?
- Will the RAC replace all current review entities?
- Will the RAC review evaluation and management (E&M) services on outpatient hospital claims?
- If a provider repays or Medicare recoups an alleged overpayment identified by the RAC and the provider later wins an appeal, will CMS reimburse the provider with interest?
- How are the RACs paid for finding underpayments?
- Do RACs look for underpayments? What happens if they find an underpaid claim?
- How long does a provider have to submit medical records when requested by a RAC?
- Under what circumstances will a RAC request medical records in order to determine if an overpayment exists?
- Under what circumstances can a RAC make a finding that an overpayment or underpayment exists without requesting medical records?
- Whose claims will be reviewed under the RAC program?
- How will the RACs determine which claims to review?
- What is the reimbursement procedure and rate for photocopy charges associated with records for RAC audits?
Click here to see the entire list of RAC FAQ.
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