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.

Advertisement

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. 

More articles on healthcare finance:
5 hospital CFOs in the headlines this week
7 recent hospital rating and outlook changes, affirmations
5 most-read finance stories: Week of Dec. 8-12

Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit

Advertisement

Next Up in Financial Management

Advertisement

Comments are closed.