AHA: Hospitals appeal nearly half of RAC claim denials

The American Hospital Association's RACTrac survey reveals continued frustration with RAC claim denials.

The AHA's RACTrac survey collects data from hospitals nationwide on a quarterly basis to assess the impact the Medicare Recovery Audit Contractor program.

Here are four findings from their third-quarter survey:

1. Hospitals appealed 47 percent of all RAC claim denials in the third quarter.

2. For 84 percent of appeals, administrative judges have exceeded the 90-day limit on providing audit appeal results.

3. About 60 percent of claims reviewed in the third quarter were found not to have an overpayment.

4. Hospitals reported inpatient coding errors as the most common reason for complex claim denials by RACs.

Since the AHA began the RACTrac survey in January 2010, 2,568 hospitals have participated, and 604 hospitals provided information in the third quarter of 2015.

AHA invites hospital representatives to attend a webinar Dec. 16 at 2 p.m. ET to review the survey results and recent RAC policy developments and help AHA advocate for necessary changes to the RAC program.

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