Hospitals have 70% overturn rate when appealing RAC claims

In the third quarter of this year, hospitals appealed 48 percent of all Recovery Audit Contractor claim denials, with 70 percent of those claim denials being overturned in the appeals process, according to the American Hospital Association's third-quarter RACTrac survey.

Since the AHA began the RACTrac survey in January 2010, 2,528 hospitals have participated, with 1,037 hospitals providing information in the third quarter.

In the first quarter of 2014, 18 percent of hospitals said they were experiencing outpatient coding denials, and that number grew to 28 percent in the third quarter.

Concerning costs, 58 percent of hospitals reported spending more than $10,000 managing the RAC process during the third quarter of this year, 39 percent reported spending more than $25,000 and 9 percent reported spending more than $100,000. 

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