Hospitals have 69% overturn rate when appealing RAC claims

Hospitals appealed 46 percent of all Recovery Audit Contractor claim denials in the fourth quarter of 2014, with 69 percent of those claim denials being overturned in the appeals process, according to the American Hospital Association's fourth-quarter RACTrac survey.

Seventy percent of hospitals indicated they experienced inpatient coding denials, which was the most commonly cited reason for RAC denials in the fourth quarter of 2014.

Concerning costs, 53 percent of hospitals reported spending more than $10,000 managing the RAC process during the fourth quarter of 2014, 32 percent reported spending more than $25,000 and 8 percent reported spending more than $100,000.

Since the AHA began the RACTrac survey in January 2010, 2,545 hospitals have participated, with 879 hospitals providing information in the fourth quarter of 2014.

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