Revenue Cycle

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.”

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