|
RAC Questions and Answers
During our RAC webinars, participants were allowed
an opportunity to ask questions. Here are a few of
those questions and the answers as follow-up to the
webinar.
- If I submit the contact form to my RAC identifying
the employee to whom requests should be mailed to,
should I follow up to get confirmation?
- If I have a medical record request, do I send in the
entire record?
- If I do an audit and find a repayment due to CMS do
I notify my RAC?
- If I receive a medical record request, can I submit
the information on a CD/DVD?
Click here for the answers....
|
|
| |
Greetings!
If you have been attending our RAC webinars, you will
find this newsletter issue an important addendum to
the information that you have already received from us
regarding CMS RAC AUDIT process.
Complex audits, those that require medical records,
will be nationwide by October/November for DRG
validation and coding errors. This should not be
confused with the CMS stay on Medical Necessity
reviews that have been postponed until 2010. Act now
to prepare your facility for these requests.
We have sited RAC activity currently in all 4 Regions.
We have a report in Tennessee for an automated audit
requesting back $39,500 for incorrect units being
billed. Because of the dollar amount they are allowing
the provider (a small physician practice) to make
payments.
ALERT: Inadvertently some systems have been coding
RAC adjustments as N469 rather than N432. Please
pay hightened attention to demand letters during this
time of confusion. CMS is working on an adjustment
to rectify this situation.
If you have not yet registered for one of our webinars, I
encourage you to check us out and register today.
This will be the perfect opportunity to ask questions of
our RAC consultant that you may not be able to get
answered easily from other sources. We have a CMS
RAC webinar this week on Wednesday November 4 at
11:00am Central Time Zone.
|
| |
| |
| |
| News Update by Region: Region A - Diversified Collection Services |
| |
Currently you are able to go to their website and enroll
a contact person for your facility. It is recommended
that you do this as soon as possible. Diversified
has posted their submission requirements.
Remember for your medical record submission to
be "accepted" you have to follow their format.
Diversified has also listed 3 vulnerabilties.
|
| |
Diversified's website... |
| |
| News Update by Region: Region B - CGI |
| |
CGI has not yet posted an option for you to submit a
contact person for your facility. Because they have not
posted the submission format they have approved, if
you receive a request it is suggested to call first before
sending off your medical record. CGI has listed 6
vulnerabilities on their site.
|
| |
CGI website... |
| |
| News Update by Region: Region C - Connolly Healthcare |
| |
Connolly has the most comprehensive site yet. 10
vulnerabilities are currently posted, their submission
requirements (extremely detailed) and a convenient
contact form for you to submit the name of your RAC
Coordinator. While we continue to hear of mostly
automated audits from this Region, there is every
indication they are ready to roll-out their complex
audits.
|
| |
Connolly website... |
| |
| News Update by Region: Region D - HealthData Insights |
| |
Region D has posted 11 current vulnerabilities and
they have supplied you a fax form to submit
your "Discussion Period" issues. They appear to be
working automated audits at this point.
|
| |
HealthData Insights website.... |
| |
| Record Submissions by CD/DVD |
| |
If you plan to submit your requested medical record by
CD or DVD, you need to know that your format must be
TIFF or PDF. Your submission must be in a tamper-
proof package. Lastly, the image file number must be
made the same as the requested claim number.
|
| |
|
| |
|
