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In letters mailed to suppliers and providers last week, Performant RAC provided notification that, per CMS authorization, certain medical review activities would again resume. Additionally, the notification provides an additional 30 days to submit discussion requests for review result and initial findings letters dated from 2/27/2020 to 3/27/2020. The notification advises suppliers to access the Provider Portal to review any claims pertaining to those dates.

The RAC posts CMS approved audit issues to their website, with complex reviews of hospital beds and manual wheelchairs being the most recently added product categories on March 1, 2020. Interestingly, these two also include dates of service details, stating, "Claims with dates of service on or after January 1, 2020 will be excluded".

This falls in line with announcements by the DME MACs last week that postpayment reviews for items/services provided before March 1, 2020 would start on August 17, 2020.

Are you audit ready? The van Halem Group can help!

From clinical prescreens of your claims to conducting proactive audits on a one-time or monthly basis, we have solutions to ensure your claims are audit ready and meet technical and clinical guidelines.

Did you receive an audit request and don't have the necessary manpower to respond with a complete and timely request? Our team of experts can review your files, provide recommendations, and even submit the request electronically on your behalf. And if the results yield overpayments, we can take on the appeals workload for you.

Contact us to learn what our team of experts can do for you!