How it Works
Urgent RAC Support
Highlighted below is an overview of the three possible scenarios you’ll likely face when your RAC communicates with you.
An overpayment demand letter is received without any corresponding request for medical records.
Request for one or more medical records is received.
An overpayment demand letter arrives after you respond to a record request.
What to Expect
RAC requests will arrive as a letter usually addressed to the physicians, the practice administrator or whomever you designated to act as the “contact person” on your CMS-855 enrollment form.
The RAC letter will always have a CMS logo somewhere on it. The better also often contains the letterhead of your RAC and your carrier, because RAC’s communicate all determinations to your carrier, which then adjusts reimbursement and records the adjustment via remittance advice. You’ll know it’s a RAC letter because it should be coming from your regional RAC.
Your RAC Letter Should Contain The Following
Your rights of appeal.
Payment refund procedures.
Audit results, indicating whether you owe an overpayment or Medicare owes you for an underpayment.
Contact information for the RAC.
The specific coverage, coding, or other payment policy (or policies) violated.