Q: If I am a chain provider whose FI is WPS (serving as the national fiscal intermediary) who will my Recovery Audit Contractor be?
A: This answer assumes the hospital originally had Mutual of Omaha as the claims processing contractor and the merger of WPS and Mutual of Omaha is how WPS became the provider’s claim processing contractor. WPS currently serves as a national fiscal intermediary in CMS. They service providers in the majority of the states. These providers have not yet transitioned to a MAC. WPS will work with all four RACs. If WPS is your claim processing contractor (as the national fiscal intermediary and not part of the local jurisdiction your RAC is based on your physical location. For example, if you are located in Tennessee, but WPS is your claims processing contractor your RAC is in Region C.
View CMS’s FAQ.
Source: CMS
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
