AHA survey: 6 in 10 RAC-reviewed claims did not have an overpayment
Hospitals participating in the AHA’s first-quarter 2016 RACTrac survey report appealing 47% of all Recovery Audit Contractor claim denials, with 60% found to have no overpayment. Participants said inpatient coding error was the most common reason RACs cited for complex claim denials. More than 81% of claims appealed to an administrative law judge took longer than the statutory limit of 90 days to provide a determination to the hospital, according to the report. Hospital representatives are invited to attend a June 28 at 2 p.m. ET to review the survey results and recent RAC policy developments. The free, web-based survey helps AHA monitor the impact of RACs and advocate for needed changes to the program. For more information, visit www.aha.org/rac.