As Medicare Recovery Audit Program Expands, Craneware Helps Healthcare Organizations with Information and Tools for Ensuring Compliance
ATLANTA, Sept. 20, 2012 /PRNewswire/ — (AHIMA Booth # 231) - According to the latest RACTrac survey by the American Hospital Association, 88 percent of the 2,266 hospitals participating in the survey reported experiencing increased Recovery Audit-related activity (formerly known as RAC). Meanwhile, the Centers for Medicare and Medicaid Services (CMS) indicated that as of June 2012, the Recovery Audit Program reported a total of $657.2 million in overpayments collected and $44.1 million in underpayments returned for $701.3 million in total corrections. This escalating rate of audited payments demonstrates the urgent need for best practices and tools for compliance, audit management and appeal. To support this demand, Craneware, Inc., the leader in automated revenue integrity solutions, today announced that its senior vice president of consulting, Karen Bowden, will offer proven, practical advice for minimizing audit exposure and succeeding in the appeals process when she presents at the 2012 AHIMA Convention & Exhibit.
Bowden’s presentation, “How to Attack Recovery Auditors at Every Level of Appeal,” will take place on Saturday, September 29, 2012 from 4:15 – 5:15 PM on Level 3, in the Lakeside Ballroom. The presentation will introduce the key elements of the Recovery Audit Program, detail the appeals process and provide strategic tips for writing a successful appeal letter. Having worked with healthcare organizations to manage and appeal RAC audits since the demonstration project (in 2010), and with an unprecedented 89% audit appeal success rate, Bowden is uniquely positioned to advise hospital executives on the best practices for appealing denials, and for embedding the processes and tools that will ensure compliance to minimize audit exposure in the first place.
“Many healthcare organizations are so busy trying to keep up with the dynamic landscape of the healthcare industry today – from healthcare reform to ever-changing regulations and legislation – that they feel they do not have the resources available to work on audit prevention and appeals,” said Bowden. “However, by implementing a few best practices and supporting staff with automated tools and up-to-date content, organizations can dramatically improve their results relatively easily. With more than 77% of audit denials overturned on appeal, it is critical that healthcare organizations arm themselves appropriately to retain all of the revenue that they rightly earned.”
Craneware’s InSight Audit(TM) is a fully hosted, Web-based solution that provides healthcare organizations with one central location for managing all medical claims audits. The solution offers a full set of features for submitting, tracking and appealing claims in response to a range of audits, including Medicare Recovery Audits, MAC audits and commercial payor audits. Craneware’s InSight Audit Knowledgebase contains the latest information on best practices and payment rules, providing valuable audit-specific content that includes templates, checklists and request forms.
To learn more about Craneware Revenue Integrity Solutions(®), visit the company’s booth, #231, at the 84(th) AHIMA Convention and Exhibit at the McCormick Place Convention Center in Chicago from September 29 – October 4.
Representing more than 64,000 specially educated Health Information Management professionals in the United States and around the world, the American Health Information Management Association is committed to promoting and advocating for high quality research, best practices and effective standards in health information and to actively contributing to the development and advancement of health information professionals worldwide. AHIMA’s enduring goal is quality healthcare through quality information. www.ahima.org.
Craneware (AIM: CRW.L) is the leader in automated revenue integrity solutions that improve financial performance for healthcare organizations. Craneware’s market-driven, SaaS solutions help hospitals and other healthcare providers more effectively price, charge, code and retain earned revenue for patient care services and supplies. This optimizes reimbursement, increases operational efficiency and minimizes compliance risk. By partnering with Craneware, clients achieve the visibility required to identify, address and prevent revenue leakage. To learn more, visit craneware.com and stoptheleakage.com.