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Updated:

Recovery Audit Contractors (RACs) for three Regions post new issues for non-medical necessity DRG validation inpatient claims reviews

Region A: The RAC for Region A, DCS Healthcare, posted three new issues for non-medical necessity DRG validation inpatient claims review for providers in District of Columbia, Connecticut, Massachusetts, Maine, Delaware, New Jersey, New York, New Hampshire, Pennsylvania, Rhode Island, and Vermont.

Region B: Region B’s RAC, CGI, added 20 new issues for non-medical necessity DRG-validation inpatient claims to its CMS-approved list for providers in all Region B states.

Region C: Connolly Healthcare posted 30 new issues for non-medical necessity DRG validation inpatient claims review for providers in the following Region C states: Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee and Texas.

If you need assistance with a RAC or third party payor audit or for more information, please visit https://www.wachler.com/ or contact a Wachler & Associates attorney at 248-544-0888.

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