News: RACTrac survey: ’Hospitals appeal 49% of denials’

The latest RACTrac survey from the American Hospital Association shows facilities 49% of denials with essentially a 25% success rate. “Almost half had an appeal overturned in their favor through use of the discussion period before a formal appeal,” the report states.

Lack of medical necessity once again topped Recovery Auditors’ denial reasoning, with nearly two-thirds of denials due to a lack of documented inpatient medical necessity.

The AHA holds a free March 27 webinar to review recent data. For information, visit www.aha.org/rac.