Health Information Management

AHA releases quarterly RACTrac survey results

HIM-HIPAA Insider, June 23, 2014

Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!

by Jaclyn Fitzgerald, Editor

 
The American Hospital Association’s quarterly RACTrac survey revealed that hospitals appealed 50% of claims denied by Recovery Audit Contractors (RAC) during the first quarter 2014, according to AHA News.
 
The AHA received responses from 1,165 hospitals. The majority of claims contested by respondents’ hospitals (63%) are still in the appeals process. However, half of respondents said their hospitals were able to overturn a denial in their favor during the discussion period before a formal appeal in the first quarter. The cost of managing the RAC process during the first quarter exceeded $10,000 for 69% of hospitals responding, whereas 47% spent upwards of $25,000.
 
Respondents attributed the majority of RAC denials to inpatient coding errors and lack of medical necessity. Respondents from more than half of the hospitals surveyed (59%) said that RACs denied their claims due to inpatient coding errors. These denials increased 8% during the last quarter. Similarly, two-thirds of respondents (66%) attributed short-stay medical necessity denials at their hospitals to placing patients in the wrong setting.
 
For information about appealing denied claims and developing an internal appeals process, join Mark Michelman, MD, MBA, and Stacey Levitt, RN, MSN, CPC,  at 1 p.m. (Eastern) Thursday, August 7, for HCPro’s 90-minute live webcast, Medicare Appeals Made Easy: A Focus on Reducing Denials.

 



Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!

    Briefings on Accreditation and Quality

  • Briefings on Accreditation and Quality

    Briefings on Accreditation and Quality will help you with all of your accreditation and survey preparation needs. Every...

  • Briefings on APCs

    Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...

  • HIM Briefings

    Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...

  • Briefings on Coding Compliance Strategies

    Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...

  • Briefings on HIPAA

    How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...

Most Popular