There is still not too much activity at the RAC Forum and there may not be until RACs begin targeting hospices. Nevertheless, we have added a new topic/category to the RAC Forum that we hope will be helpful. It is called “Claim Denial Reasons.” At the moment we do not know what issues the RACs will review for hospices but it is likely they will be similar to what RHHIs have reviewed in the past. At Weatherbee Resources we have noticed an increase in spurious reasons for claim denials with our ADR clients. Given the concerns about RACs overreaching as well, we thought it might be a good opportunity to begin gathering information about this from other hospices. The advantage is that together we can begin to think about strategies for appealing these denials, seek advocacy from NHPCO, or, if nothing else, rant about how unfair or bizarre things have become.
This article has been posted on two sites: homehealthnews.org and racassistance.com. Leave your comments and stories of your experiences at either site and Heather Wilson and Tim Rowan will consolidate them and keep track of important news that should be shared industry-wide.
