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Medicare Compliance & Reimbursement

Recovery Audit Contractors:

RACs ID Insufficient Documentation As Weakness Among Practices

Published on Sun Jul 04, 2010

Stay on top of RAC requests so you're able to meet all request deadlines. Recovery audit contractors (RACs) can retroactively deny your claims for a number of reasons -- but one that can easily be remedied is lack of medical documentation on your practice's part. If a RAC requests your medical documentation and you don't send it -- or you submit incomplete or illegible records -- your payments can be denied. Plus, money that your MAC already sent to you can be recovered back to the carrier in cases of nonexistent or incomplete documentation. The issue of incomplete documentation was identified by CMS recently as a "high dollar improper payment vulnerability," and the agency issued MLN Matters article SE1024 to discuss the topic and explain to providers that documentation should be a top priority. "Coders should be catching insufficient documentation before a claim leaves the office, but in some cases, [...]
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