Helen Adamopoulos: 10 Key Stats From The Medicare Recovery Auditor Survey (RAC)

1. The hospitals surveyed reported 57 percent didn't contain an overpayment
2. Nearly 60 percent of hospitals reported experiencing short-stay medical necessity denials
3. 59 percent of hospitals received denials for inpatient coding
4. Sixty-six percent of short-stay denials for medical necessity were because the care was provided in the wrong setting
5. Hospitals reported appealing 50 percent of their RAC denials
6. Hospitals reported a 66 percent success rate in the appeals process
7. Fifty-five percent of hospitals filing a RAC appeal during the first quarter appealed short-stay medically unnecessary denials
8. Of the participating hospitals' appealed claims, 63 percent are still in the appeals process
9. Sixty-nine percent of hospitals spent more than $10,000 managing the RAC process during the first quarter
10. 48 percent of hospitals surveyed reported spending more than $25,000 managing the RAC process

Source: Beckers Hospital Review
Source URL: http://www.beckershospitalreview.com/finance/medicare-rac-ac...

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