The number of RAC claim denials is up 24% relative to last quarter, according to the most recent results of the AHA’s RACTrac survey. Medical necessity denials represented the top reason for RAC denials, however, two-third of these were for care found to be provided in the wrong setting, not because the care provided was medically unnecessary. Survey respondents are appealing more than 40% of denials with a success rate of 75%. Hospital representatives are invited to attend a free Sept. 18 webinar on the survey results and how to participate in the free web-based survey, which helps hospitals monitor the impact of RACs and advocate for needed changes to the program. For more information, visit http://www.aha.org/advocacy-issues/rac/ractrac.shtml.
AHA survey shows dramatic increase in RAC activity