Tag: Performant Recovery
Audit round up: RACs cut checks, UPICs run roughshod
June 28, 2019Theresa Flaherty, Managing Editor
YARMOUTH, Maine - Nearly two years after Performant Recovery announced it would perform an underpayment review for Group 3 power wheelchair options, providers are receiving refund checks, says Andrea Stark.
Performant, the DMEPOS RAC, announced in May 2017 it would review wheelchair accessories, including seating systems, and seat and back cushions furnished in conjunction with codes K0848—K0864 for the six-month period of Jan. 1, 2016—June 30, 2016. The review was necessary because...
Regulatory: Performant, CGS
May 23, 2019HME News Staff
WASHINGTON - Performant Recovery, the National DMEPOS RAC Contractor, has added upper limb orthoses to its approved issues list. Performant will review claims for upper limb orthoses with dates of service within five years of the date of service of a previously paid upper limb orthoses for the same beneficiary. HCPCS codes identified as same, for the same anatomical site, will be denied as the reasonable useful lifetime requirement has not been met� The Jurisdiction B and C councils met recently...
RAC to perform rare underpayment review
May 18, 2017HME News Staff
ATLANTA - Performant Recovery, the DMEPOS RAC, will perform an underpayment review for Group 3 power wheelchair options. The Patient Access and Medicare Protection Act mandates that adjustments to the 2016 Medicare fee schedule amounts for certain DME based on information from the competitive bidding program cannot be applied to wheelchair accessories, including seating systems, and seat and back cushions furnished in connection with codes K0848—K0864. The change was effective Jan. 1, 2016...
New RAC starts 'slow and steady'
March 24, 2017Liz Beaulieu, Editor
LIVERMORE, Calif. - Performant Recovery was officially up and running as of March 8, but the new national RAC for HME is taking its time ramping up its activities.
Peformant posted seven new reviews for everything from chest wall oscillation devices to complex Group 2 support surfaces in February. But it had not posted any additional reviews as of late March.
“I would expect that they would add one or two edits every seven days to staff up to where they were at previously with known issues,”...
New RAC posts new reviews
February 24, 2017HME News Staff
WASHINGTON - Performant Recovery, the new national recovery audit contractor (RAC) for DMEPOS and home health/hospice, has posted seven new reviews on its workload page, according to AAHomecare. They are: complex medical necessity chest wall oscillation devices; complex medical necessity tracheotomy suction catheters, suction pumps, catheters and other related supplies and equipment; automated nebulizers not in accordance with billing requirements; automated DME billed while inpatient; complex review...
Providers prep for return of RAC
November 18, 2016Liz Beaulieu, Editor
LIVERMORE, Calif. - Providers should strap in: After a protracted lull, RAC audits will likely pick back up in January, now that CMS has tapped Performant Recovery, based here, to perform post-payment reviews for DME and home health/hospice claims nationwide.
Stakeholders say Performant will likely kick-start its efforts with reviews* it had previously been performing as the RAC for Jurisdiction A—reviews whose targets were everything from vacuum erection devices to respiratory assist devices...
In brief: CMS names nat'l RAC for DME, whistleblower drops lawsuit against Lincare
November 4, 2016HME News Staff
WASHINGTON - CMS has tapped Performant Recovery to perform post-payment reviews of Medicare claims for DMEPOS and home health/hospice nationwide.
The other RACs awarded contracts will perform post-payment reviews to identify and correct Medicare claims that contain improper payments that were made under Part A and Part B for all provider types other than DMEPOS. Performant Recovery also won that contract for Region 1. Cotiviti won contracts for Region 2 and 3, and HMS Federal Solutions won a contract...
CMS taps Performant for nat'l RAC for DME
November 2, 2016HME News Staff
WASHINGTON - CMS has tapped Performant Recovery to perform post-payment reviews of Medicare claims for DMEPOS and home health/hospice nationwide.
The other RACs awarded contracts will perform post-payment reviews to identify and correct Medicare claims that contain improper payments that were made under Part A and Part B for all provider types other than DMEPOS. Performant Recovery also won that contract for Region 1. Cotiviti won contracts for Region 2 and 3, and HMS Federal Solutions won a contract...
New DME RAC program on hold
January 15, 2015HME News Staff
WASHINGTON - Performant Recovery has filed a Government Accountability Office (GAO) bid protest against CMS.
The protest, filed Jan. 6, comes on the heels of the agency's announcement that it had selected Connolly as the recovery audit contractor (RAC) to oversee the national program for DME, home health and hospice.
Wilton, Conn.-based Connolly is the current RAC for Jurisdiction C, while Performant Recovery in Livermore, Calif., is the contractor for Jurisdiction A.
The national...