Monitoring Accounts Receivable that are in a Redetermination or Reconsideration Status

120 – Monitoring Accounts Receivable that are in a Redetermination or Reconsideration Status (Rev. 261, Issued: 01-29-16, Effective: 03-01-16, Implementation: 03-01-16) The MAC shall develop controls to monitor accounts receivable (ARs) that are in the first (redetermination) or second (reconsideration) level of appeal. ARs that are in either level of appeal are subject to limitations on recoupment as mandated by Section 935(f)(2)(a) of the Medicare Modernization Act of 2003. The MAC shall monitor these ARs to make sure the “days in status” are not greater than 120. If the “days in status” are greater than 120, the MAC shall research the appeal to determine the status/decision of the appeal and update the AR’s status accordingly.