RAC Demand Letters Replaced

CMS Transfers Responsibility

By Staff Reporters

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January 2012 marks a significant change for Recovery Auditors as the Centers for Medicare & Medicaid Services (CMS) is transferring the responsibility for demand letters from the auditors to claims processing contracts. The reason for the change is “to avoid any delays in demand letter issuance,” according to MLN Matters article 7436.

The Result

As a result, when a Recovery Auditor finds improper payments, they will submit claim adjustments to your Medicare (claims processing) contractor. The contractors will carry the responsibility of fielding concerns throughout the time frame of the payment recovery and the appeals process.

Assessment

Read the full article here.

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