Wiki RAC short stay and timely filing

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colsonccsp@yahoo.com

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Deer Park, TX
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Hey there,

I have a case that was for a RAC audit where in the IN claim was challenged and in truth it should have been an OBS case. RAC recouped the money for the inpatient case and we are attempting to rebill for the OBS level of service. We are being denied for timely filing.

Does anyone have any experience with this and if so what are you doing to get your money for the corrected claim? The claim is 2 years old, they just recouped the money a few months ago. I don't think we should have to eat this service but I am not sure how to deal with them to get around the timely filing for the service converted from IN to OBS.

Any thoughts, ideas or stories about what your practice does would be appreciated.
 
was it ordered as an observation at the time and billed incorrectly or did the patient not meet inpatient criteria and it was billed incorrectly? either way if it was ordered as inpatient at the time and billed as in then the recoup is correct and you are out of timely filing, if it did not meet inpatient criteria at the time it should have been caught at that time and the recoup is correct. I cannot see anyway for you to do this at this juncture for payment. If the is no order on the chart for obs status you cannot now 2 years later write an order to convert to inpatient and you cannot bill what the chart does not support.
 
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