RAC notifies providers of reviews

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Friday, August 21, 2020

WASHINGTON – Performant, Medicare’s RAC, has notified providers by letter that, per authorization from CMS, it will resume certain medical review activities, according to the van Halem Group.

The notification says providers have an additional 30 days to submit discussion requests for review for result and initial findings letters dated Feb. 27, 2020, to March 27, 2020. It also advises providers to access the Provider Portal to review any claims pertaining to those dates.

Performant most recently posted CMS-approved complex reviews for hospital beds and manual wheelchairs to its website on March 1, 2020.

The van Halem Group noted that these reviews specifically include dates of service details: “Claims with dates of service on or after Jan. 1, 2020, will be excluded,” Performant states.

“This falls in line with announcements by the DME MACs that post-payment reviews for items/services provided before March 1, 2020, would start on Aug. 17, 2020,” the van Halem Group stated.

CMS announced in July that it would resume audit activities in August.