Hospitals have 60% overturn rate when appealing RAC claims

Hospitals appealed 45 percent of all Recovery Audit Contractor claim denials in the third quarter of 2016, with 60 percent of those claim denials being overturned in the appeals process, according to the American Hospital Association's third-quarter RACTrac survey.

Concerning costs, 43 percent of hospitals reported spending more than $10,000 managing the RAC process during the third quarter of 2016, 24 percent reported spending more than $25,000 and 4 percent spent more than $100,000.

Since the AHA began the RACTrac survey in January 2010, 2,580 hospitals have participated, and 683 hospitals provided information in the third quarter of 2016.

 

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