This book includes a plain text version that is designed for high accessibility. To use this version please follow this link.
● Recovery Audit Contractor (RAC) Solutions Guide

Audit request quick turnaround HealthPort is ex- cited to launch our


ment Audit Solutions featuring AudaPro, HIHPRO and HIHPRO+. This suite is designed to help health information management, finance and compliance departments effectively manage increased audit ac- tivity. 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 re- quests in hours will help decrease turnaround times as well as help facilities avoid technical denials. HealthPort

See HealthPort at HIMSS13 booth #6841

Expert help for coding compliance

The 3M Audit Expert System iden- tifies compliance issues by reviewing 100 percent of coded inpatient re- cords at the point of coding. The soft- ware 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 compli- ance process. With periodic assessment and analysis of coding out- put, 3M can help organizations reduce compliance risk and capture lost reimbursement. 3M

See 3M at HIMSS13 booth #2341, Interop Showcase

Enhanced payer audit tracking

AUDITRENDS Online (for- merly Audit Tracker Online) ex- pands the functionalities of tra- ditional RAC software to allow healthcare providers to manage

all payer audit processes, including MAC and ZPIC, and enforce appropri- ate 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

Compare and conquer RemitDATA’s


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

26 March 2013 Streamline RAC requests

When the recovery audit contractors arrive, are you prepared to defend your claims? SSI’s ClickON RADs (Re- covery 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 neces- sary 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

Claim adjudication and more

Emdeon EDGE provides complete payment integrity and cost contain-

ment services designed to help detect improper healthcare claims and prevent inaccurate payments. This solution leverages the market-lead- ing expertise of The Sentinel Group, EquiClaim and TC³ Health and inte- grates 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

InSightful audit reporting

Craneware’s InSight Audit is a compre- hensive, Web- based audit management

tool that helps hospitals develop and maintain an efficient and trans- parent 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 applica- tion designed to manage and streamline audit reporting, tracking and workflow challenges. Craneware All-encompassing RAC solution

Revenue Integ- rity Compass is more than RAC tracking – it’s a

comprehensive business technology solution that protects current revenues from audit activity across all payers, systematically address- es 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 im- provement and best-in-class audit outcome analysis. The Advisory Board Co.

See Advisory Board at HIMSS13 booth #4669


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32