The SOW added the following provisions:
• CMS’ oversight of the RACs has been increased to guarantee workloads are met.
• RACs will review all types of Medicare providers and claims.
• RACs will review all healthcare providers referred by CMS and other government auditors.
• Semi-automated review is established, which will allow RACs to gather additional information from providers before making automated denials.
Related Articles on RACs:
CMS Increases RAC Record Request Limit for Providers With Low Medicare Claims
How to Navigate the RAC Appeals Process
AHA: 93% of RAC Complex Denials Involve Medical Necessity
