Medical necessity top reason for RAC denials

The number of recovery auditor (RAC) denials for hospitals has increased 23 percent in the third quarter of 2012, according to the American Hospital Association's RACTrac survey. Medical necessity denials remained the leading reason for a RAC recoupment since the first quarter of 2010. Meanwhile, about 40 percent of all denials are appealed by hospitals, with a 74 percent success rate in getting the recoupments overturned during the process. --Read the full story at FierceHealthcare

Suggested Articles

Humana filed suit Friday against more than a dozen generic drugmakers alleging the companies engaged in price fixing.

Nominations are open for our 2020 FierceHealthcare Fierce 15 awards. Think your company has what it takes? Submit your nominations here.

Medicare Advantage open enrollment kicked off last week, and insurers are taking new approaches to marketing a slate of supplemental benefit options.