Health Information Management

Understand new AHA RACTrac initiative

HIM-HIPAA Insider, May 12, 2009

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Q: I’ve heard that the American Hospital Association (AHA) will be tracking the effects of the national RAC rollout. Is this true?

A: Yes, the AHA plans to launch a Web-based survey as part of a larger RACTrac initiative this fall to track the effects of RACs on individual hospitals nationwide. The survey will require hospitals to report on a quarterly basis their RAC experience. RACTrac will collect the following data points:

  • Number of claim denials and total dollars associated with over payments and underpayments
  • Service areas where overpayments are being identified (e.g., inpatient, outpatient, rehab, etc.)
  • Reasons for claim denials cited by the RACs
  • Number of appeals filed and the dollars associated with those appeals
  • Quantifying administrative burden and costs by hours of staff dedicated to managing the RAC process and dollars paid to consultants

AHA has also created a member advisory that explains the initiative and provides answers to frequently asked questions about how hospitals can participate in the survey.

In addition, AHA has provided a list of vendors that currently provide claim-level RAC audit solutions, meaning they have expressed an interested in making their applications compatible with the RACTrac initiative.



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