tci Medicare Compliance & Reimbursement - 2010 Issue 8

RAC Apeals: Don't Let RACs Shoot Down Your Whole Claim for A Small Error

These examples show how you may be able to recoup part of your denied claim, even if you have to give up a portion of the reimbursement. Some providers aren't taking what they view as unfair RAC denials lying down.Case in point: A durable medical equipment company is appealing a Recovery Audit Contractor recoupment involving what the RAC claims to be noncompliant billing for a power wheelchair. The billing allegedly violated some bundling rules that are part of a local coverage decision, reports attorney Amy Fehn, whose law firm is handling the appeal for the DME provider. "The...

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