The American Hospital Association's quarterly RACTrac survey shows hospitals continue to appeal Recovery Audit Contractor claim denials, often to their benefit.
AHA's RACTrac survey collects data from hospitals on a quarterly basis to assess the impact of the Medicare Recovery Audit Contractor program on hospitals nationwide. Using the data collected, AHA aims to inform CMS and Congress of pain points and other problems that need to be addressed.
Here are four findings from AHA's latest survey, published Oct. 6.
1. Hospitals reported appealing 45 percent of all RAC claim denials.
2. About 60 percent of claims reviewed in the second quarter of 2016 were found not to have an overpayment.
3. Hospitals reported RACs cited inpatient coding errors as the most common reason for complex claims denials.
4. Three in four claims appealed to an administrative law judge required longer than the statutory limit of 90 days to issue a final ruling.
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