This article at FierceHealthFinance.com says that Medicare’s recovery audit contractors are keeping up pressure on claims denials, according to a new survey by the American Hospital Associations.
AHA’s voluntary RACTrac survey on Medicare recovery audit contractor activity has reported $19.2 million in denied claims during the second quarter of 2010, including $11 million in Medicare Region C, according to data compiled by RACTrac. The region, which comprises the Southeastern U.S., represents about 36 percent of the RACTrac participants.
Most of the denials–both automated and complex–came from coding and billing errors. Altogether, about 16 percent of the RAC denials that may be appealed have been appealed. About $421,000 worth of denials have been overturned.
The data is among the first reported by RACTrac, which became active in January 2010. According to the AHA, 1,389 hospitals are participating. Of those, 972 facilities–or 70 percent–have reported RAC activity. Most of those are non-teaching hospitals with 200 or fewer beds.
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The Centers for Medicare and Medicaid Services (CMS) has announced a series of “Nationwide RAC 101 Calls.” The calls, open to the public healthcare community, are scheduled for late April and early May as follows:
- April 28, 2010 1:00pm - 2:30pm EST: Nationwide RAC 101 Call, 1-877-251-0301
- May 4, 2010 1:00pm - 2:30pm EST: Nationwide RAC 101 Call for Home Health and Hospice Providers, 1-877-251-0301
- May 5, 2010 1:00pm - 2:30pm EST: Nationwide RAC 101 Call for DMEPOS, 1-877-251-0301
- May 12, 2010 1:00pm - 2:30pm EST: Nationwide RAC 101 Call for Physicians, 1-877-251-0301
For updated call schedule information, go to http://www.cms.gov/RAC/03_RecentUpdates.asp#TopOfPage
