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Home Health & Hospice Week

Audits:

Follow These 6 Rules For Appealing Unfair RAC Denials

Published on Tue Mar 09, 2010

Even if you're dead wrong on an issue, check out this often overlooked escape hatch. Recovery Audit Contractors have already begun multiple durable medical equipment audits, and home health agencies and hospices could be next on their hit list. To get ready for RAC denials and your appeals, check out these potential pitfalls and tips for winning. Rule No. 1: Know who you are up against. "RACs aren't likely to deny anything where they don't believe they have ... a 90 percent chance of recovering money," says Pauline Franko of Encompass Consulting & Education in Tamarac, Fla. And, "you can figure the RAC is going to fight tooth and nail to make sure a denied claim stays denied upon appeal," says Victor Kintz with Polaris Group based in Tampa, Fla. That's because "the outcome will affect whether or not they will be paid for the work done on that claim." [...]
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