Health Information Management

News: RACTrac report finds hospitals appeal 50% of denials

CDI Strategies, June 19, 2014

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Of all the Recovery Auditor denials, hospitals reported appealing about 50% with more than a 50% success rate—it’s 50/50 game that hospitals cannot afford to not play, according to the American Hospital Association’s recent RACTrac report.

The report also shows short-stay medical necessity denials continuing as a Recovery Audit focus area for 59% of hospitals. Facilities reported that 66% of short-stay denials were due to care provided in the wrong setting, not because the care wasn’t warranted.

Hospital representatives are invited to attend a June 24 webinar to review recent RAC policy developments and results from the survey.

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