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20
Sample tool: Draft RAC appeal letter
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You have limited time to respond to a RAC demand letter and to provide the medical records necessary to appeal any denials. Consider this sample letter to help ensure your response is thorough and effective.
Click here to view the Draft RAC Appeal document.
Editor’s note: The sample letter is reprinted courtesy of Tanja Twist, MBA/HCM, director of patient financial services for Methodist Hospital in Arcadia, CA, and The HIM Director’s Guide to Recovery Audit Contractors published by HCPro, Inc.
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At which level of appeal was this letter used? Also, the RAC will be auditing for medical necessity, so that argument will not be pertinent. If the RAC was not supposed to audit for medical necessity in the demonstration project, how is it that 62% of the take backs were for medical necessity?