Performant is now the RAC for all Part A and Part B Medicare National Government Services in Jurisdiction K – Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut and New York.

As part of the audit process, Performant may request specific items or complete records to support the billing and coding of the claim(s) under review. Performant has reported to Medicare that there is a large increase of providers who are not returning the documentation requested for review.

As a reminder, if you receive a request for additional information from the RAC, it’s important that you return the information as requested within the time frame noted by the RAC.

When requested records are not received, the case is automatically found unfavorable, the service(s) are denied, and recoupment of paid services occurs. As a result, the provider would need to initiate an appeal and continue through that process by submitting necessary documentation, which can be time consuming and costly for your organization.

To avoid unnecessary delays and potentially incorrect findings:

• submit the documentation requested to the RAC to support the billing and coding of the claims under review
• submit within the RAC requested time frame
• send one complete submission of records.
  • Do NOT send multiple submissions of records.
  • Submissions may be sent via esMDvi, to learn more visit Electronic Submission of Medical Documentation (esMD) | CMS.

Additional information specific to JK (Region 1) and provider resources can be found on the PERFORMANT website.