CMS data shows that providers won appeal decisions for more than 43% of the Medicare Recovery Audit Contractor (RAC) claims that they appealed in FY2011, which represents almost $38M.
Of the 900K claims that RACs determined were overpayments, 56K were appealed by providers. Decisions were made in favor of the provider in nearly 25K of those claims.
A closer look at the numbers reveals that providers won the most money back when they appealed complex reviews.
Tags: ACA, CMS, Medicaid RAC, RAC