Providers who are the subject of a RAC review where an overpayment is believed to have been made will receive a demand letter from the RAC. Sample letters can be found on your contractor’s website:
- Region A: Diversified Collection Services
- Region B: CGI Technologies and Solutions
- Region C: Connolly Consulting
- Region D: HealthDataInsights
Demand letters will come from your Medicare contractor. You will be able to tell that it is related to a RAC audit from the “R” preceding the letter number. The letter will also contain information on problems with claims you have submitted and how you can either repay the funds or appeal the determination.
You should also be able to tell that you have been the subject of an audit based on the remittance advice on your Explanation of Benefits (EOB). It will likely be indicated with the Remark Code N432: Adjustment Based on Recovery Audit. However, you should receive the demand letter before receiving the EOB with this remark code, so this indication of recoupment should not be your first notice of the audit.