Q: What is the name and contact information for each RAC?
A: Contact information for each RAC by region is as follows:
• Region A: Diversified Collection Services
1-866-201-0585
• Region B: CGI
1-877-316-7222
• Region C: Connolly Consulting
1-866-360-2507
• Region D: HealthDataInsights
1-866-590-5598 (Part A), 1-866-376-2319 (Part B and suppliers)
Q: Will the RACs review evaluation and management services on physician claims under Part B?
A: Yes, the review of all E & M services will be allowed under the RAC program. The review of duplicate claims or E & M services that should be included in a global surgery were available for review during the RAC demonstration and will continue to be available for review. The review of the level of the visit of some E & M services was not included in the RAC demonstration. CMS will work closely with the American Medical Association and the physician community prior to any reviews being completed regarding the level of the visit and will provide notice to the physician community before the RACs are allowed to begin reviews of E & M services and the level of the visit.
Q: Who should providers contact with questions concerning RAC communications?
A: Providers should first attempt to contact the Recovery Audit Contractors (RAC) through the customer service line. If that does not answer the provider’s questions and/or concerns, then the provider can contact CMS. CMS has set up a special email address for the provider community to use. It is CMS RAC@cms.hhs.gov.
Q: Why is CMS using recovery audit contractors?
A: Section 306 of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 required CMS to complete a demonstration project to demonstrate the use of recovery audit contractors in identifying underpayments and overpayments and recouping overpayments under the Medicare program for services for which payment is made under part A or B of title XVIII of the Social Security Act. The demonstration operated from March 2005 through March 27, 2008. Section 302 of the Tax Relief and Health Care Act of 2006 required the Department of Health and Human Services to make the RAC program permanent and nationwide by no later than January 1, 2010. CMS is planning a gradual expansion to all 50 states. The expansion schedule can be viewed at www.cms.hhs.gov/RAC.
View all CMS RAC FAQs.
Source: CMS.
