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Home Health & Hospice Week

Industry Note:

RAC Focuses On RAPs Without Final Claims

Published on Thu Jun 14, 2012

Add one more HHA issue to the approved list of RAC audit topics. Recovery Audit Contractor Connolly Healthcare recently posted "RAP claim without corresponding home health claim" as an approved audit issue. Connolly is the RAC for Region C covering Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West Virginia, and Puerto Rico.The topic is interesting, because the Medicare claims system is supposed to automatically recoup a RAP payment when the agency fails to submit a final claim within 60 days of the RAP payment. But apparently the system isn't always doing that. "After data research of Medicare claims database, RAP claims were identified without a corresponding home health final claim," Connolly says on its website.CMS doesn't believe the RAP problem is widespread, the National Association for Home Care & Hospice reports.This topic joins one other approved issue for home health [...]
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