As recovery audit contractors (RAC's) accumulate more claims denials, hospitals must put more resources into improving their claims processing records, according to Becker's Hospital Review. Recent figures from the Center for Medicare and Medicaid Services indicate that RAC's have collected almost $218 million in overpayments since they began using automated reviews in 2009. Hospitals can protect themselves by double-checking claims, implementing documentation improvements programs, digitizing records and keeping up with deadlines.
According to Paul Spencer, compliance officer for physician practice financial management company Fi-Med Management, a hospital's RAC activity is likely to significantly decrease if clinical documentation improvement programs are effectively put into practice.
"When an RAC starts coming up with nothing at a particular hospital, it will realize it cannot make any money here and will move on to easier opportunities," he told the news source.
Taking preventive steps before an RAC investigation can save hospitals a lot. According to Fierce Health Finance, the average RAC audit recovered $398 on an outpatient claim and $5,200 on an inpatient claim.