by Heather Wilson
There is not much new since the update last week so we will provide a recap of the current status of each RAC.
For Region A, Diversified Collection Services is the only RAC that has not posted any approved issues on its website and therefore has not begun any automated reviews. Their website provides a copy of a sample demand letter which is helpful to review. DCS’s website also provides detailed instructions regarding how to submit records as well as providing contact information. The FAQs on the DCS website are directed to hospitals but may be useful to review. All hospices in Region A should bookmark the DCS website and review it often.
For Region B, CGI was the third RAC to post issues approved by CMS for automated review. CGI has posted three issues for outpatient hospitals and physicians that it has been approved to review in Indiana, Michigan and Minnesota. This has no relevance for hospices. CGI’s website is very easy to navigate and providers in Region B should bookmark the website and review it often. The FAQs are quite comprehensive and helpful. In addition, CGI has scheduled an outreach session specific to hospices and home health through the Midwest Center for Home, Hospice and Palliative Education on September 9th from 9:00 to 10:30 AM. Hospices located in Region B should try to attend this outreach call. Click here to register on line or here to download a registration form. It might even be helpful for hospices outside of Region B to listen in to get an idea (hopefully) of how the RACs and CMS plan to address hospice issues.
Region C – Connolly Healthcare is the leader in posting approved issues on its website. Currently, Connolly has posted six issues for outpatient hospitals and physicans in Florida and South Caroina, 1 issue for outpatient hospitals and physicians only in South Carolina, and, most recently, an issue for Clinical Social Workers who provide services during inpatient hosptial stays in Florida only. The Connolly website is difficult to read due to the unnecessarily small font size but should be bookmarked by hospices in Region C and reviewed often. It includes sample demand letters for both automated and complex reviews.
Region D – HealthDataInsights (HDI) has posted seven approved issues for all states in Region D and has begun automated reviews of hospital claims. HDI has posted sample fax forms to use to initiate a “discussion” of RAC claim denials. The HDI website has limited FAQs, a useful RAC User Guide and the promise of more “coming soon.” Hospices in Region D should bookmark the website and visit it regularly.
