Problems, Glitches with
Manual Medical Review (MMR)
Manual Medical Review with RACs began April 1, 2013.
If problems with the MMR process arise, contact AHCA through its new Manual Medical Review Clearing House at ManualReview@AHCA.org
AHCA to Channel Members Manual Medical Review Issues to CMS
RACs are reviewing therapy claims that exceed $3,700 in 11 states through the end of 2013 (CA, FL, IL, LA, MI, MO, NY, NC, OH, PA, TX). All other states (39) will have post-payment review. Go here for more details.
Called “manual medical review,” and required by Congress, AHCA has taken steps to continuously channel providers’ problems with the process to CMS through the AHCA Manual Review Clearinghouse at email@example.com. If a provider is facing a problem that it cannot get resolved, we ask that the provider email the problem to the clearinghouse at firstname.lastname@example.org.
On the positive side of the manual review process, CMS is requiring RACs to complete prepayment reviews within 10 days and we especially want to hold them to this timeframe.