Posts Tagged ‘CGI’

Recovery Audit Contractors (RAC) HealthDataInsights (HDI) and CGI Federal have added to their list of new issues eligible for review as per the Centers for Medicare & Medicaid Services (CMS).

The RAC program, mandated by the Tax Relief and Health Care Act of 2006, is being implemented in 2010 to detect and correct past improper Medicare payments.

Tip: Don’t wait until Jan. 1, 2010 to review these new issues and correct any problems your outpatient hospital or physician practice may uncover. Read more »

CGI Federal’s first set of approved issues for Recovery Audit Contractor (RAC) review in Region B is now available.

Following HealthDataInsights and Connolly Healthcare’s lead, the approved issues target outpatient hospital and physician claims and include blood transfusions, IV hydration, and bronchoscopy services.

All three RACs will be looking for overpayments due to excessive units reporting. For blood transfusions, IV hydration, and bronchoscopy services, you should bill a maximum of 1 unit per patient, per date of service.

Look for additional information regarding these RAC-approved issues, including affected codes and policy-related links, on CGI’s Web site.

If audited, a provider has an initial discussion period to present additional information to support the services billed. If the provider does not agree with the decision, then the provider has 120 days from date of the First Demand Letter to file an appeal of the determination.

On Oct. 6, 2008, the Centers for Medicare & Medicaid Services (CMS) announced that CGI Technologies and Solutions, Inc. of Fairfax, Va., was awarded Region B, initially working in Indiana, Michigan and Minnesota and later adding Illinois, Kentucky, Ohio and Wisconsin.

CGI may be contacted by phone at (877) 316-7222 and by e-mail at racb@cgi.com.

Gearing up for the 2010 implementation of the Recovery Audit Contractor (RAC) program,  HealthDataInsights (HDI) and Connolly Healthcare are the first to post issues eligible for review.

The RAC program, mandated by the Tax Relief and Health Care Act of 2006, is being implemented to detect and correct past improper payments so that the Centers for Medicare & Medicaid Services (CMS), claims processing contractors, and providers can take action to prevent future improper payments. Read more »

The Centers for Medicare & Medicaid Services (CMS) announced Feb. 6 that the permanent Recovery Audit Contractor (RAC) program is set to begin March 1. The bidding protests filed by Viant, Inc. and PRG Schultz, USA, Inc., which caused a Stop Work order in October 2008, are resolved.

Read more »