Revenue Cycle

Prepare for impending RAC medical necessity reviews

Recovery Auditor Report, May 13, 2010

There has been much speculation as to when providers would see the first wave of medical necessity RAC reviews; but the May 5 nationwide RAC 101 call helped to dispel a bit of that uncertainty.

In the second nationwide RAC 101 conference call for DMEPOS, CMS addressed the imminent arrival of medical necessity reviews for the permanent RAC program, stating that providers might see medical necessity reviews “within the next month or so,” according to Scott Wakefield, project officer, CMS. He added that, “We don’t have a specific time frame for it but it will begin soon.”

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