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AHA survey: Hospitals appealing nearly half of RAC claim denials

from AHA News Now

Hospitals continue to appeal Recovery Audit Contractor claim denials, according to the latest report from the AHA's quarterly RACTrac survey. Hospitals participating in the fourth quarter of 2014 survey report appealing 46 percent of all RAC claim denials, with a 69 percent overturn rate in the appeals process. In addition, more than half of all appealed claims are still sitting in the appeals process, and hospitals report that claims audited under the RAC prepayment demonstration have, on average, a greater dollar value than claims audited retrospectively. more


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