AHA survey: Hospitals appeal half of RAC claim denials

Hospitals continue to appeal Recovery Audit Contractor claim denials, according to the latest report from the AHA's quarterly RACTrac survey. Hospitals participating in the third-quarter 2015 survey report appealing 47% of all RAC claim denials. For more than 84% of claims appealed to an administrative law judge, the judge has taken longer than the statutory limit of 90 days to provide a determination to the hospital, according to the report. About 60% of claims reviewed in the third quarter were found to not have an overpayment. Hospitals also report that RACs cite inpatient coding error as the most common reason for complex claim denials. Hospital representatives are invited to attend a webinar Dec. 16 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.