Revenue Cycle

Confusing the rebuttal process with the discussion period

Medicare Update for CAHs, January 25, 2012

The following question and answer is an exchange between a reader and the Revenue Cycle Institute team:

Question: I’m new to handling RAC audits, so I was reading up on the rebuttal process, also known as the “discussion period,” which must be filed within 15 calendar days of the date on the demand letter. I called my RAC (Connolly Healthcare) and was told that the rebuttal letter along with the “stop recoupment” letter should go to my local Medicare administrative contractor (MAC).

The letter we received from Connolly states that we are to notify the “claim processing contractor” and they will review and advise of their decision within 15 days. I’m confusing about who should be receiving the rebuttal letter. When I spoke with Palmetto (our MAC) they were under the impression that I submitted an appeal letter and that they have 60 days to respond. Can you please clarify?

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