Revenue Cycle

From the field: Discovering errors when receiving an ADR

Recovery Auditor Report, April 21, 2011

While reviewing medical records as part of an additional documentation request, a RAC coordinator in a Region C hospital recently identified a claim that should not have been billed to CMS. The RAC coordinator wanted to know if—in addition to sending an immediate offset form of the funds received to CMS—should she still send the medical records with an explanation that the claim should not have been billed?

As it turns out, the answer is yes. The RAC coordinator submitted the question to Connolly, the RAC for Region C, and their answer is as follows:

“Please continue to submit the medical record for this claim even if you sent the immediate offset form.”

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