Georgia RAC Update—Medical Necessity Reviews

Connolly Healthcare is the Medicare recovery audit contractor (RAC) for Region C, which includes Georgia. Connolly commenced operations in the RAC Permanent Program in August 2009, performing automated reviews, which involved audits for clearly erroneous payments that can be determined without the need for review of additional documents beyond those already in the possession of the government. Since then, however, Connolly has been slow to ramp up its operations for more complex reviews, such as those that involve review of the medical necessity of services performed.

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