Q. If I receive a letter from the Medicare Recovery Audit Contractor regarding overpayment, do I have any options other than to either pay up or launch an appeal?
A. The Recovery Audit Contractor (RAC) discussion period provides an opportunity for you open up a dialogue with the Connolly, Inc., the RAC for Texas, regarding overpayments. The discussion period begins when you receive a demand letter under an automated review, or a letter with the results of a complex review, and ends at recoupment of the money, i.e., day 41, unless you’ve come to some other agreement with Connolly.
You can use this period to try to change the RAC’s mind on a denial in some circumstances, or learn how the RAC made the determination so you don’t keep making the same mistakes. It may be a way to avoid an appeal. Note, however, that the discussion period does not replace the appeals process or extend your appeal timeframes.
You should contact Connolly as soon as possible during the discussion period — don’t wait until day 39 or 40. Generally it is more effective to discuss like denials as a group, rather than one at a time. Be sure to track your communications throughout the discussion period.
TMA Practice E-tips main page
Last Updated On
June 03, 2016
Originally Published On
March 24, 2010