ED Coding and Reimbursement Alert

Check out the chart showing the 5 levels of RAC appeals and the related filing deadlines.

This chart lays out the five levels of RAC appeals process. AIC in the chart refers to the amount in controversy, which must be satisfied in order access that given level of appeal. It is important to know that recoupment by the MAC occurs on the 41st day unless the first appeal is filed in 30 days, even though there are over 70 days to actually file the appeal. Currently the ALJ appeals are over 2 years behind in scheduling hearings because of the volume of claims reaching that level.