AHA survey: 6 in 10 RAC-reviewed claims did not have an overpayment

Hospitals participating in the AHA’s third-quarter 2016 RACTrac survey report appealing 45% of all Recovery Audit Contractor claim denials, with 60% found to have no overpayment. Hospitals also report that RACs cite inpatient coding error as the most common reason for complex claim denials, and three in four claims appealed to an administrative law judge took longer than the statutory limit of 90 days to provide a determination to the hospital. Hospital representatives are invited to learn more about the survey results and recent policy activities impacting the RAC program during a webinar Dec. 13 at 2 p.m. ET. AHA staff will provide an update on the Centers for Medicare & Medicaid Services’ award of new RAC contracts, the latest on CMS’s reopened settlement offer for hospitals appealing denials of certain inpatient status claims and what health care providers can expect moving forward.