From the field: CMS Q&A on the discussion period
Recovery Auditor Report, March 22, 2012
After reading about another provider’s Recovery Auditor correspondence woes in a February 23 post on the Revenue Cycle Institute, Shelia Handy, RN, BSN, RAC coordinator for Lake Charles Memorial Hospital in Lake Charles Louisiana, offered her input on the matter.
Handy had emailed Connolly regarding a discussion that was submitted according to their preferred method, stating in an e-mail sent February 3, 2012:
“I submitted a discussion letter on January 12, 2012 for claim # XXXXXX via fax. I submitted timely to prevent recoupment of money within the CMS stated timeframe for recoupment. Is it possible to get a response on the discussion letter submission?”
Connolly returned correspondence, stating:
”The auditor has 30 days, per CMS, to respond to the discussion request. However, we suggest beginning your appeal process once you receive the demand letter rather than file a discussion with Connolly. The time frame for recoupments and appeals with your payer begins once you receive the demand letter.”
Related Products
-
Core Skills for Hospital Case Managers:
A guide to fundamental case management responsibilities, Core Skills for Hospital Case Managers serves as a training...
-
The RAC Toolkit for Hospitals and Health Systems
The RAC Toolkit for Hospitals and Health Systems: Manage Responses and Avoid Claims Under the Permanent Program is your...
-
The 2013 Medicare Compliance Forum: Las Vegas, NV
-
Level of Care Determinations for 2014: Las Vegas, NV
Attend the half-day seminar, Outpatient, Observation or Inpatient? Continuing to Walk the Tightrope of Regulatory Guidance...
-
OPPS and IPPS Reimbursement Fundamentals: Las Vegas, NV
Attend OPPS and IPPS Reimbursement Fundamentals, a half-day seminar on October 2nd in Las Vegas. Learn how CMS’ substantial...
Most Popular
- Articles
-
- CMS seeks comment on quality measures
- Don't forget the three checks in medication administration
- Practice the six rights of medication administration
- The consequences of an incomplete medical record
- Note similarities and differences between HCPCS, CPT® codes
- Nursing responsibilities for managing pain
- ICD-10-CM coma, stroke codes require more specific documentation
- Neurological checks for head injuries
- Q&A: Primary, principal, and secondary diagnoses
- Skills of effective case managers
- E-mailed
-
- Establish an ongoing records review process with five easy steps
- Know the JCAHO's ongoing records review requirements
- Tip: Report drugs with HCPCS code, revenue code 636
- The pros and cons of geographic rounds
- Know the medical gas cylinder storage requirements
- Know the JCAHO's ongoing records review requirements
- Hold a scavenger hunt to prepare for survey
- Clear up confusion surrounding observation services
- Assisted living home owner bills Medicaid from unlicensed facility
- Analyzing nurse staffing: Understanding FTEs
- Searched