Revenue Cycle

Recent change in CMS manual aims to improve RAC program

Recovery Auditor Report, May 13, 2010

A recent transmittal released by CMS implemented a number of changes to the Medicare Financial Management Manual that will ultimately enhance the structure of the RAC national program.

The transmittal, Change Request 6871, is dated April 23, 2010 with an effective date of May 24, 2010. Changes include Chapter 4 Sections 100.5 and 100.9.2.(You can read the transmittal here: http://www.cms.gov/transmittals/downloads/R167FM.pdf)

Chapter 4 Section 100.5: Adjusting the Claim

The transmittal discusses updated language in chapter four of the manual, including the implementation of an N432 code with the remittance advice (RA) to denote its relationship to a RAC audit. An RA is a notice of payments and adjustments sent to providers, billers, and suppliers.

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