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HIPAA/HITECH Privacy Breach Management
HIPAA Compliance Audits
Claims Audit Management
Medicare RAC Audit Management
Medicaid RAC Audit Management
How to successfully manage Medicare & Medicaid Audits
MIC Audit Management
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Healthcare – Medicare RAC Audits
Managing RAC, MAC and other Medical Claims Audits
Medicare RAC, MAC and other medical claims audits embody significant risk to legitimate revenues and profit margins for healthcare providers. These audits typically include very complex appeals processes with stiff penalties such as the automatic recoupment of funds if appeals deadlines are missed, even by as little as one day.
To further complicate matters, the introduction of the Medicaid RAC program as mandated by the Healthcare Reform legislation adds a new level of complexity certain to jeopardize the legitimate revenues of healthcare providers. State Medicaid agencies are permitted to use their current appeals process, modify their existing process, or devise an entirely new process for Medicaid RAC audits.
The importance of using a flexible claims audit software system capable of handling all medical audit types has never been more pronounced. Healthcare providers need a solution that can help them take control of the entire audit process, including their initial response to record requests, determining if and when to appeal denied claims, and ensuring timely replies throughout the appeals process.
After working with hundreds of hospitals managing RAC and other medical claims audits, we’ve encountered challenges and requirements that are very consistent from one organization to the next. From this, we’ve identified the requirements that we believe are critical to achieving success with any Claims Audit solution. Click here to read what we've learned.
The Compliance 360 Claims Audit Manager helps healthcare providers manage a wide variety of medical claims audits and appeals, including Medicare RAC, MIC, Medicaid RAC, MAC, ZPIC, CERT, PERM, MFCU and others. Claims Audit Manager is part of the industry leading Compliance 360 solution for healthcare that enables a comprehensive approach to regulatory compliance and risk management through one comprehensive, enterprise-wide platform.
With the Compliance 360 Claims Audit Manager for CMS Medicare RAC Audits, you can:
Demonstrations of the Compliance 360 Claims Audit Manager
To learn more about using the Compliance 360 Claims Audit Manager to manage your RAC audits and appeals we invite you to view a recorded demonstration of the system:
Compliance 360 Claims Audit Manager: Take Control of RAC Audits
To request a personal demonstration of the Compliance 360 Claims Audit Manager, please Contact Us.
Free Claims Audit Training (Live and On-Demand Webinars)
You are also invited to attend our live broadcasts or replay our on-demand recorded training webinars at your convenience. These training webinars have been attended by more than 10,000 participants and have received very positive feedback. Click Here for the full list of live and on-demand training webinars.
To learn how other healthcare organizations are using Compliance 360's Claims Audit Manager, we invite you to download the following case studies:
To learn how leading healthcare providers are using Compliance 360 to minimize their compliance overhead and risks, and how you can be doing the same, Contact Us today.
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