As of April 1, Region C recover audit contractor Connolly Consulting stopped including recovery amounts for overpayments in its demand letters. The contractor previously included projected recovery amounts but stopped this practice after realizing it and the Region C MAC contractors were using different calculation tools, leading to significant differences between the estimated amount and the actual recoupment amount from the MAC, according to a blog post by J. Paul Spencer, compliance officer for Fi-Med, and author of The RAConteur blog.
"One wonders why CMS missed the important step of verifying that the dollar amounts from the RACs and the MACs matched," he states.
In response, Mr. Spencer recommends providers compare the amounts of review letters to those recouped by RACs. "Go forward on the assumption that the amounts determined by the RACs are estimates only," he says.
Read the blog post here.
Related Articles by J. Paul Spencer:
8 Actions Hospitals Can Take to Protect Against RACs
As Denials Rise, Hospitals Working Harder to Fend Off RACs
"One wonders why CMS missed the important step of verifying that the dollar amounts from the RACs and the MACs matched," he states.
In response, Mr. Spencer recommends providers compare the amounts of review letters to those recouped by RACs. "Go forward on the assumption that the amounts determined by the RACs are estimates only," he says.
Read the blog post here.
Related Articles by J. Paul Spencer:
8 Actions Hospitals Can Take to Protect Against RACs
As Denials Rise, Hospitals Working Harder to Fend Off RACs