Reminder Regarding RAC ADR Limits for O&P Services

AOPA would like to remind its members that revised limits for Additional Documentation Requests (ADRs) for RAC audits involving O&P claims were implemented as of April 3, 2013.

While the ADR calculation remains unchanged at 10% of claims submitted during the previous year, divided by 8, for each 45 day period, CMS has limited the number of ADR requests for O&P providers to a maximum of 10 ADR requests every 45 days.

AOPA has received several reports where members have received ADR requests after April 3, 2013 that exceed the maximum of 10.

If you receive more than 10 ADR requests from a RAC auditor within a 45 day period, please contact the RAC contractor immediately to challenge the request.  In addition, please contact Joe McTernan so that AOPA may address this issue with CMS directly.