News: CMS reduces Recovery Auditor claim request minimum
April 25, 2013
CDI Strategies - Volume 7, Issue 9
CMS seems to be giving hospitals of a reprieve when it comes to Recovery Auditor (RA) denials. CMS published guidance April 5 stating it would reduce the minimum number of RA requests from 35 records to 20 records every 45 days. This reduction went into effect April 15.
CMS will also impose a 75%—rather than 100%—limit on any particular claim type. This means that RAs can select up to 75% of any claim type for review. Claim types include IPPS, OPPS, skilled nursing facility, inpatient rehabilitation facility (IRF), inpatient psychiatric facility, ambulatory surgery center, or physician claims.
Editor’s Note: This article was originally published on JustCoding.com.