Revenue Cycle

Recent RAC Activity

Recovery Auditor Report, August 19, 2010

DCS Healthcare posts 10 new RAC issues for non-medical necessity inpatient claims

DCS Healthcare added 10 new RAC issue for non-medical necessity inpatient claims review to its CMS-approved list this week for providers in Connecticut, Washington D.C., Delaware, Massachusetts, Maine, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont.View the new issues by visiting the DCS website.

CGI adds 25 new RAC issues across two categories

CGI, the RAC for Region B, added seven new issues for non–medical necessity DRG validation claims review; and 18 new issues for medical necessity claims review to its CMS-approved list for providers in all Region B states.

View the new issues by visiting the CGI website.

Connolly modifies an existing issue

Connolly, the RAC for Region C, modified an existing RAC issue for outpatient hospital claims for all states in Region C.

According to the Connolly website, the issue “medically unlikely edit list,” is now “Failure to correctly bill codes on the medically unlikely edit list.”

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