Monday, May 23, 2022

RAC Audits

Lori Jack

Good news everyone on a recent RAC audit for L5980… I just received a
letter from HDI stating “HDI has concluded that its overpayment
determination should be overturned. Accordingly, HDI has therefore
determined that no overpayment exists related to the claim/line on the Audit
Finalization.” I actually submitted in writing, a “Discussion Period to
Recovery Auditor Request” after receiving my Review Results Letter and
Refund Demand Letter stating the services submitted were not reasonable and
necessary. I was going to go straight to the Redetermination level of
appeal, but thought I’d try the “Discussion Period” route first. I
submitted this on October 18th and received a letter today dated October
31st so the turnaround time is pretty fast, which allowed me to not have to
cut a check to Medicare.

If you haven’t done so on past RAC audits, I would highly recommending
trying the “Discussion Period” route first, prior to submitting a
Redetermination… it certainly wouldn’t hurt.

Good luck everyone. it’s a tough time for us all J

Lori Jack

Office Manager

Northern Care, Inc.

Prosthetics & Orthotics

[email protected]

210 Windward Way

Kalispell, MT 59901

406-755-6322 phone

406-755-6324 fax

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