Posted on Friday, January 26, 2018 2:41 PM
Recovery Audit Contractor or RAC performs post payment review for Medicare (CMS) to identify claims that contain improper payments. CMS must approve any “issue” that is selected for review. On January 10, 2018 the HH&H RAC, Performant, posted the issue “Complex Home Health review: Documentation and Medical Necessity”. The RAC is targeting the following revenue codes: 027X (Medical/surgical supplies), 042X (Physical Therapy), 043X (Occupational Therapy), 044X (Speech-Language Therapy), 055X (Skilled Nursing), 056X (Medical Social Services) and 057X (Home Health Aide). Agencies will receive a letter from Performant with all the necessary information needed and how to submit the documentation.
Here is the link to the Performant Region 5 for more details on the issue, resources and forms:
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