Question everything…especially when it comes to claims!
43% of RAC appeals win according to CMS RAC appeals update*
It pays to appeal claims — at least that’s what 43% of hospitals and other providers learned in 2011. Of the 56,620 claims that were appealed, 43.4% received a ruling in favor of the provider.
While automated claims were overturned in favor of provider more often (57%) than complex claims (19%), the dollar amount for complex claims overturned was $29.95 million (79%) versus $5.94 million (16%).
The bottom line: if you’re not appealing claims you could be missing out on revenue that your practice has rightfully earned!
Learn ways you can boost revenue and reduce risk with coding training or a coding audit from DoctorsManagement.
If you have questions about this topic or any other issues around the business of medicine, contact us via email or call us at 800-635-4040.