Revenue Cycle

Finding success in the RAC discussion period

Recovery Auditor Report, April 1, 2010

Since the implementation of the permanent RAC program, providers may not be taking full advantage of the discussion period, but as review results letters continue to arrive, this notion could change.

The RAC discussion period begins with the time that either the demand letter (automated reviews) or review results letter (complex reviews) is received through the time recoupment occurs, according to CMS. This period of time was implemented by CMS as a way for providers to have an open discussion about how a RAC may have made their determination and allow the provider to provide additional information. Questions have been surrounding the discussion period since the beginning of the permanent RAC program, but it is a valuable resource for providers looking to avoid the appeals process, according to Debbie Mackaman RHIA, CHCO, regulatory specialist for HCPro, Inc.

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