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Your NPI number is now required to log into the Provider Portal.
With the provider portal, you can:
Click here to visit our welcome page.
Whether you're new to RAC or to working with Cotiviti, we have resources to help you.
Region 2 Transition
On March 24, 2022, CMS awarded Performant Recovery, Inc., the new Recovery Audit Contractor (RAC) Region 2 contract. RAC Region 2 includes the following Medicare Administrative Contractor (MAC) jurisdictions: J5, J6, and JH.
Cotiviti, LLC, the RAC previously responsible for reviews in Region 2, remains under contract with CMS to support the RAC Program from an administrative and appeals perspective in this region. Please contact Cotiviti in regards to reviews conducted by Cotiviti. All notification of improper payments, including review results letters (complex reviews), informational letters (automated reviews) and no findings letters (complex reviews) were completed by Cotiviti, in Region 2, on or before Friday, September 16, 2022.
CMS anticipates Performant will begin reviews in the Spring (2023). RAC Region 2 providers can rely on the review completion date specified in the review results letter, as well as the RAC’s name on the letter, to identify which contractor to reach for inquiries. If Performant receives inquiries in regards to reviews conducted by Cotiviti, Performant customer service will inform providers to reach out to Cotiviti and vice versa.
Region 2 Contact Information:
Cotiviti, LLC
www.Cotiviti.com/RAC
RACinfo@Cotiviti.com
1-866-360-2507
Performant Recovery, Inc.
https://performantrac.com/providerportal.aspx
info@Performantrac.com
1-866-201-0580
Additional Documentation Limits for Medicare providers (except suppliers and physicians)
Effective May 1, 2022, the Centers for Medicare & Medicaid Services (CMS) has modified the additional documentation request (ADR) limits for the Medicare Fee-for-Service Recovery Audit Contractor (RAC) program providers. Additional information can be found on the CMS RAC Program Resources website.
The Centers for Medicare & Medicaid Services (CMS) is required to protect the Medicare Trust Fund against inappropriate payments which pose a risk to the Trust Fund. Therefore, we are resuming Medicare Fee-for-Service medical review activities. The COVID-19 Public Health Emergency (PHE) continues to be monitored very closely. Providers should contact Provider Service at 866-360-2507 or racinfo@cotiviti.com to discuss any COVID-19 related hardships and to request any necessary extensions.
The Centers for Medicare & Medicaid Services (CMS) is required to protect the Medicare Trust Fund against inappropriate payments which pose a risk to the Trust Fund. Therefore, we are resuming Medicare Fee-for-Service medical review activities. Due to the ongoing national coronavirus disease 2019 (COVID-19) pandemic, and the potential need for providers and suppliers to allocate their resources to public health activities, we are temporarily limiting complex reviews to Dates of Service preceding March 1, 2020.
The Centers for Medicare & Medicaid Services (CMS) is required to protect the Medicare Trust Fund against inappropriate payments which pose a risk to the Trust Fund. Therefore, we are resuming Medicare Fee-for-Service medical review activities. Due to the ongoing national coronavirus disease 2019 (COVID-19) pandemic, and the potential need for providers and suppliers to allocate their resources to public health activities, we are temporarily limiting reviews to Dates of Service preceding March 1, 2020.
Please see the updated COVID-19 FAQs in the April 27th section below.
For information related to COVID-19 and the current national emergency please see the following:
CMS Current Emergencies Page
Provider Burden Relief FAQs
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.
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.
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.
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).
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.
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).
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
Please download and enter your request in Adobe Acrobat.
Update Your Contact Information - Individual Provider
Address, fax, email, contact of record
Update Your Contact Information - Multi-Provider
Address, fax, email, contact of record
Logging in and navigation
Methods and formatting requirements
Fillable Discussion Request Form
Please download and enter your request in Adobe Acrobat.
Address, fax, email, contact of record
Address, fax, email, contact of record
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
All CMS-approved reviews by type and state
Thorough answers to quick questions
Additional documentation request from Cotiviti
(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
Cotiviti - CMS Recovery Audit
Hillcrest III Building
731 Arbor Way, Suite 150
Blue Bell, PA 19422
Cotiviti CMS Recovery Audit
Program Director - Region 3
Michael Hoffman
michael.hoffman@cotiviti.com
Dr. James Lee, D.O.
Medical Director
CMS Manuals
CPI/CMS
Medicare Coverage Database
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.
