RAC Updates July through September 2012

Listed below are the RAC issues which were approved for this past quarter.  These issues include hospital-specific along with physician and other types of providers.

Region A: DCS
As of August 15, Diversified Collections Services, Inc (DCS) changed their name to Performant Recovery, Inc. They are a subsidiary of Performant Financial Corporation.
Performant has twelve states. There were eleven issues approved for this past quarter. All apply to CT and NY. For the remaining ten states (DC, DE, MA, MD, ME, NH, NJ, PA, RI, VT) some, but not all of the issues apply.

  • Outpatient Hospital:  One Semi-Automated,  One Automated
  • Inpatient Hospital:  Two Complex
  • Physician/Non-Physician Practitioners:  Three Automated
  • Laboratory:  One Automated
  • DME by Supplier:  Two Complex
  • Ambulatory Surgical Center:  One Automated

 

Region B: CGI
Region B consists of MN, WI, MI, IL, IN, OH, KY.  There have been no new issues posted since May 2012.

 

Region C:  Connolly
Connolly is the largest region, covering 35% of all claim volume for 17 states and territories.  These include AL, AR, CO, FL, GA, MI, NM NC, OK, Puerto Rico, SC, TN, TX, Virgin Islands, VA, and WV.
Effective August 20, 2012 Connolly has a new address and all correspondence is to be sent to this address. Phone, fax and email remained the same.

Connolly Healthcare
555 North Lane Suite 6125
Conshohocken PA 19428

For July through September there were twelve issues approved.

  • Physician:  One Complex, One Automated
  • DME Non-Physician Supplies: Two Complex, Two Automated
  • Outpatient Hospital:  Two Complex, Two Automated,  One Semi-Automated
  • Other Carrier Biller: One Automated

 

Region D:  Health Data Insights (HDI)
HDI has 17 states and three territories. These are AL, AZ, CA, HI, IA, ID, KS, MO, MT, ND, NE, NV, OR, SD, UT, WA, WY, Guam, American Samoa, and Northern Marianas.
The eleven approved issues are for the following:
SNF:  Two Issues

  • Outpatient Hospital:   Three Issues
  • Inpatient Rehabilitation Facility:  One issue
  • Outpatient:  Two Issues
  • Physician:  Three Issues

 

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