CMS RAC

With the provider portal, you can:

  • Check your claim review status 24/7
  • View results
  • Update contact information
  • Export data


The Provider Portal will be temporarily unavailable due to maintenance from Friday August 23, 2019, at 7:00 pm EST to Sunday August 25, 2019 at 7:00 pm EST.

New to working with Cotiviti?

Click here to visit our welcome page.

Whether you're new to RAC or to working with Cotiviti, we have resources to help you. 

CONTRACT UPDATES: 

Recent update: April 8, 2019

CMS often receives referrals of potential improper payments from the MACs, UPICs, and Federal investigative agencies (e.g., OIG, DOJ). At CMS discretion, CMS may require the RAC to review claims, based on these referrals. These CMS-Required RAC reviews are conducted outside of the established ADR limits.

 
Recent update: December 11, 2018

As of Friday, December 11, 2018, access to the Provider Portal will require an email address, password, and an authentication code. For more information, please see the Provider Portal User Guide located in the "How-to materials" section.

 
Recent update: October 3, 2018

Effective October 8, 2018, our new address is:

Cotiviti, Inc.

Hillcrest III Building

731 Arbor Way, Suite 150

Blue Bell, PA 19422

Please send all correspondence to this address.  Our other contact information (phone, fax, and email) remains the same.

 

Recent update: April 23, 2018

Medicare FFS Recovery Audit Contractors (RACs) are approved by CMS to review Periodic Interim Payment (PIP) Providers under CMS New Issue #0001 MS-DRG Validation.  Claims that are selected for review will have ADRs sent within 6 months of the date of services for facilities receiving Periodic Interim Payments (PIP).

 

Recent update: January 9, 2018

As of 1/31/2018, the Region C contract will be closed and all Cotiviti provider support services for these claims will end.  As of this date, Region C claims will not be displayed on the Provider Portal and Provider Service will not be able to respond to inquiries.  If you have questions about a Region C claim(s) after 1/31/18, please contact your Medicare Administrative Contractor.  Please note:  This does not apply to Regions 2 and 3.  The auditing activity for these regions will continue.

 

March 6, 2017
Audit Activity Begins 

CMS has given approval for Cotiviti to begin audit activity for RAC Regions 2 and 3.  Click here to be taken to the CMS Approved Issues list.

Click here to see a description of prior Recovery Audit contract modifications, and their effective date(s).  

How-to materials

Use the Provider Portal

Logging in and navigation

Submit Documentation

Methods and formatting requirements

Submit a Discussion Request or Physician-to-Physician Review

Fillable Discussion Request Form

Update Your Contact Information - Individual Provider

Address, fax, email, contact of record

Update Your Contact Information - Multi-Provider

Address, fax, email, contact of record

Knowledge Base

Approved Issues

All CMS-approved reviews by type and state

RAC Frequently Asked Questions

Thorough answers to quick questions

Sample ADR

Additional documentation request from Cotiviti

Contact Us

Provider Service

(866) 360-2507
RACinfo@Cotiviti.com
(inquiries only, no medical documentation)

Provider Service Specialists are available Monday through Friday from 8:00 am to 6:30 pm EST excluding federal holidays

Fax: (203) 529-2995

 
Mailing Address

Cotiviti - CMS Recovery Audit
Hillcrest III Building
731 Arbor Way, Suite 150
Blue Bell, PA 19422

 

Program Oversight

Cotiviti CMS Recovery Audit
Program Director - Region 2
Kenneth Turturro
Vice President
kenneth.turturro@cotiviti.com

Dr. Joby Varghese, D.O. FACOI
Medical Director

Cotiviti CMS Recovery Audit
Program Director - Region 3
Michael Hoffman
michael.hoffman@cotiviti.com

Dr. James Lee, D.O.
Medical Director

 

Additional Information

CMS Manuals

Council for Medicare Integrity

Medicare Coverage Database

Medicare FAQ

Recovery Audit Program Overview

Cotiviti.com Accessibility and Compliance with Section 508

Click to Download Adobe Acrobat Reader

 

For more information about the availability of auxiliary aids and services, please visit: https://www.medicare.gov/about-us/accessibility/accessibility-aids.html.