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 Solutions Guide

Recovery Audit Contractor (RAC) Solutions Guide

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   March 2013

Audit request quick turnaround

HealthPort is excited to launch our Government Audit Solutions featuring AudaPro, HIHPRO and HIHPRO+. This suite is designed to help health information management, finance and compliance departments effectively manage increased audit activity. Our distribution gateway to esMD via HealthPort Connex now reduces the costs associated with processing government audits by providing fast, secure, electronic submissions. Delivering audit requests in hours will help decrease turnaround times as well as help facilities avoid technical denials. HealthPort

See HealthPort at HIMSS13 booth #6841
www.rsleads.com/303ht-151

Streamline RAC requests

When the recovery audit contractors arrive, are you prepared to defend your claims? SSI’s ClickON RADs (Recovery Audit Defense system) helps you keep the payments you were due without dedicating a small army to their defense. Designed to streamline the acceptance of RAC requests, efficiently collect and attach necessary documentation from various departments and generate complete, timely RAC responses, RADs minimizes the time spent on these non-revenue-generating tasks. SSI

See SSI at HIMSS13 booth #2251
www.rsleads.com/303ht-152

Expert help for coding compliance

The 3M Audit Expert System identifies compliance issues by reviewing 100 percent of coded inpatient records at the point of coding. The software helps hospitals respond quickly to RAC requests and defend claims through the appeals process. 3M Audit Expert is also offered with 3M Consulting Services to address key areas of the coding compliance process. With periodic assessment and analysis of coding output, 3M can help organizations reduce compliance risk and capture lost reimbursement. 3M

See 3M at HIMSS13 booth #2341, Interop Showcase
www.rsleads.com/303ht-153

Claim adjudication and more

Emdeon EDGE provides complete payment integrity and cost containment services designed to help detect improper healthcare claims and prevent inaccurate payments. This solution leverages the market-leading expertise of The Sentinel Group, EquiClaim and TC³ Health and integrates that technology and experience with Emdeon’s vast healthcare network. The result is a powerhouse solution that easily integrates within the existing claim adjudication workflow to provide accurate claim payments throughout the adjudication lifecycle. Emdeon

See Emdeon at HIMSS13 booth #5027
www.rsleads.com/303ht-154

Enhanced payer audit tracking

AUDITRENDS Online (formerly Audit Tracker Online) expands the functionalities of traditional RAC software to allow healthcare providers to manage all payer audit processes, including MAC and ZPIC, and enforce appropriate billing procedures and deadline management across the enterprise. The customizable software – with detailed trend analyses – manages patient information, workflow, correspondence, audit determinations, various stages of appeals processes, deadlines and documents in one central, secure location. esMD electronic delivery to CMS can be used through MRO’s connection to the NwHIN. MRO Corp.

See MRO Corp. at HIMSS13 booth #149, 245
www.rsleads.com/303ht-155

InSightful audit reporting

Craneware’s InSight Audit is a comprehensive, Web-based audit management tool that helps hospitals develop and maintain an efficient and transparent audit process resulting in success rates much higher than the national average. InSight Audit leverages a knowledgebase of best practices, payment rules and audit-specific content that enables standardization and efficiencies. The software is a powerful application designed to manage and streamline audit reporting, tracking and workflow challenges. Craneware

www.rsleads.com/303ht-156

Compare and conquer

RemitDATA’s TITAN product is the only comparative analytics solution in healthcare that gives providers the same level of E&M Utilization tracking and benchmarking capability that Medicare, payers and RAC auditors use. TITAN is the leading SaaS-based solution that enables providers to compare their code utilization to their peers, by specialty and location. By using TITAN, providers can see which physician, location or department might be an outlier for a RAC audit. RemitDATA

See RemitDATA at HIMSS13 booth #7823
www.rsleads.com/303ht-157

All-encompassing RAC solution

Revenue Integrity Compass is more than RAC tracking – it’s a comprehensive business technology solution that protects current revenues from audit activity across all payers, systematically addresses clinical documentation issues to prevent future losses, minimizes compliance risk and identifies underpaid claims. Members have proven results: fewer financial losses, better insight into documentation improvement and best-in-class audit outcome analysis. The Advisory Board Co.

See Advisory Board at HIMSS13 booth #4669
www.rsleads.com/303ht-158


Tags:  Solutions Guide