Health Information Management

CMS releases updated RAC Statement of Work

CDI Strategies, September 15, 2011

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CMS updated its Recovery Audit Contractor Statement of Work (SOW), according to an article in AHA News Now. The new SOW calls on RACs to review all Medicare claim-types and types of providers. It also asks RACs to increase semi-automated reviews which allows the contractors to ask providers for additional information prior to issuing perhaps unwarranted automated denials.

The SOW also requires better organization of RAC websites; more appropriate notification of the reasons for denials; and a guaranteed RAC discussion period for all claim denials, giving providers an opportunity to reverse denial decisions without entering the formal appeals process, according to AHA News Now.

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