Updated on: February 6, 2019

RAC Alert: Erroneous ADR Letters Sent by WPS GHA

By
Original story posted on: August 24, 2018

Error reported by WPS/GHA  might have nationwide ramifications.

Medicare Administrative Contractor (MAC) WPS GHA today confirmed that an enhancement to its Fiscal Intermediary Shared System (FISS) caused erroneous additional documentation request (ADR) letters to be sent to providers.

In a posting to its website, WPS GHA reported that the error occurred Aug. 6, but its system was updated on Aug. 17, adding that ADRs now are “ordering appropriately.” WPS GHA is the Part A MAC for regions J5 and J8 and include providers in Idaho, Kansas, Missouri, Indiana, Mississippi, and Nebraska.

“Providers should monitor ADRs generated between August 6, 2018, and August 17, 2018,” WPS GHA said, noting that it is “working with the FISS maintainers to identify the claims that have received an erroneous letter, and WPS GHA will override those claims manually.”

Ronald Hirsch, MD told RACmonitor that he hopes hospitals will not expend too much effort sending out charts that were requested in error.

Chuck Buck

Chuck Buck is the publisher of RACmonitor and is the program host and executive producer of Monitor Monday.

This email address is being protected from spambots. You need JavaScript enabled to view it.

Related Articles

  • Medicare Audit Contractors Demand Providers Perform Self-Audits
    Although the details of federally ordered auditing of providers have changed over the years, one thing remains the same. We have lived for years under the Sword of Damocles – the continuing waves of healthcare audits by federal contractors. The…
  • BREAKING: MAC Advises Providers to Appeal Denials
    “Urgent” memo marks obvious disagreement among contractors. In what can only be described as highly unusual, a Medicare Administrative Contractor (MAC) has advised home health providers who have had claims audited and denied by the Comprehensive Error Rate Testing (CERT)…
  • BREAKING: CMS Stops MAC Recoupment of Short-Stay Denials
    Latest move by CMS raises more questions. CGS, a Medicare Administrative Contractor (MAC), on Thursday released an email notice indicating that the Centers for Medicare & Medicaid Services (CMS) has instructed it to stop seeking recoupment or issuing demand letters…