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Provider Contact Information

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RAC Request for Provider Contact Information

Performant Recovery is the Recovery Audit Contractor (RAC) for Regions 1 and 5. Please provide your contact information for both Medical Record Requests and Review Results Letters/Discussion Period Letters below. If you represent multiple facilities/providers, please complete this form for each facility/provider or you can complete the Excel spreadsheet linked below.  If you utilize the Excel spreadsheet, email the completed form to our RAC Customer Service Team.

Provider Contact Information Spreadsheet.xls

Please ensure all required fields are completed in each section.

Contact for Recovery Medical Record Requests

Review Results/Discussion Period Result Letters

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