In the first quarter of 2013, Medicare auditors targeted $8.7 billion for medical record requests, according to hospitals participating in the AHA's latest RACTrac survey. The quarterly survey hones in on hospitals' experiences with the federal government's RAC program.
According to the survey, 91 percent of responding hospitals reported RAC activity in the first quarter, up slight from 90 percent in the last quarter of 2012. Hospitals reported appealing 44 percent of denials and winning 72 percent of those cases.
Among other findings:
- Region A — the Northeast — had the highest number of medical record requests per hospital
- 58 percent of records reviewed by RACs did not contain an improper payment
- $1.9 billion in denials were reported though the first quarter of 2013
- 96 percent of denied claims were for complex denials
- The average dollar amount of an automated denial was $755, the average amount of a complex denial was $5,441
The AHA is holding a webinar June 19 for hospital officials to review recent developments in RAC policy and RACTrac results.