Nov

26

Q&A: Interacting with a RAC

By The RAC Report

Q: One of the challenges that many providers have faced is the inability to sufficiently interface (e.g., to see a human, get a return phone call, or otherwise interact in a personalized manner) with a RAC with respect to questions, concerns or confusion that occasionally arise. Will the permanent RACs be more welcoming of human interaction?

A: Yes. When you contact the RAC, they are required to return a phone call within one business day. In the permanent program, if a provider calls during the second period—or at any time—to discuss a determination, the RAC is required to let the provider speak to the medical director or the person that reviewed the claim.

Editor’s note: This Q&A was adapted from the November 13 RAC Open Door Forum. A CMS representative answered this question.