Mashcom appeals Prepay and Postpay Audit Appeals RAC services, MAC services Stop recoupment appeal letters Postpay audit appeals Audit Appeals letters

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Prepay and Postpay Audit Appeals

Audit appeals Demand Letters QIC Letters ALJ Letters


What is RAC?

RAC is Recovery Audit Contractors which deals with Prepay and Postpay audit appeals and they are responsible for identifying improper medicare payments and implement action accordingly to reduce these improper payments.

What service will Mashcom provide?

Mashcom helps in handling Prepay and Postpay appeals. We have experienced certified physicians, healthcare executives who can guide you through the appealing process regarding overpayment denials. Since written appeal request is required, our physicians write an appeal letter on your behalf considering the medical records and by following industry standard guidelines such that you get winning Prepay and Postpay appeal.

What is MAC?

MAC is Medicare Administrative Contractors which deal mainly with Prepay audit appeals. They also have few Postpay accounts too.

Will the RAC affect me?

Yes, in case you bill for the fee-for-service program then all your claims will be reviewed by RAC's

How to Stop Recoupment?

You can stop recoupment process, if you are submitting an appeal within the deadline that is specified. For Level 1 cases, you have to submit your redetermination appeal within 30 days from the date of first request letter to stop recoupment. In case the decision at this level is unfavorable then you can appeal to level 2(QIC) within 60 days from the date of redetermination decision.

What guidelines does Mashcom follow?

Mashcom follows two main industry standard guidelines like Milliman and InterQual. Inpatient admission is justified using these two guidelines.

What are the Advantages and Disadvantages in Using the Limitation on Recoupment Provision?

Providers can take advantage of the limitation on recoupment provision by not repaying the overpayment during the first and second levels of the appeals process. The pitfall, however, is that interest will still continue to accrue during that entire time. If a physician loses at either of the first two levels and they elected not to repay their overpayment determination during the appeal, then they will owe medicare both the principal overpayment determination amount and accrued interest.

Who writes your RAC Letters?

All your RAC letters are written by experienced certified physicians who are completely aware of the medical literature that RAC follows and understand the importance of industry standard guidelines.

How many levels of Appeals do you write?

Mashcom prominently deals with MAC (Medicare administrative contractors), Level1 (demand), Level 2(QIC- Qualified intermediate contractors) and Level 3(Administrative Law Judge).