Recovery Audit Contractors (RACs) recently posted new issues approved for review:
The RAC for Region A, DCS Healthcare, added three RAC issues for non-medical necessity claims for providers in the District of Columbia, Maine, Delaware, New Jersey, New York, New Hampshire, Pennsylvania, Rhode Island and Vermont.
CGI, the RAC for Region B, added a new issue for non-medical necessity DRG-validation inpatient claims and a new issue for durable medical equipment (DME) claims to its CMS-approved list for providers in all Region B states.
Connolly Healthcare, the RAC for Region C, added 6 new issues for outpatient hospital reviews and 12 issues for non-medical necessity DRG validation reviews for providers in Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia (WPS only), West Virginia (WPS only).
The RAC for Region D, HealthDataInsights, added one new issue for Part B reviews for providers in all Region D states.
More detailed information about each approved issue is available on the RAC’s website. If you need assistance with a RAC or third party payor audit or for more information, please visit www.racattorneys.com or contact a Wachler & Associates attorney at 248-544-0888.