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RAC Management Solution from CareMedic Drives Superior Preparation and Management of Entire Recovery Audit Contractor (RAC) Process
ST. PETERSBURG, Fla.-(Business Wire)-September 4, 2008 - CareMedic Systems, Inc., a leader in proactive financial management for hospitals and providers, today announced the launch of a new solution to help hospitals prepare for, track and effectively manage the entire Recovery Audit Contractor (RAC) process. CareMedic’s RAC Management solution works in combination with the powerful capabilities of its MedicareRT™ direct entry solution and offers a host of new functionality, including new claim edits specifically addressing known RAC audit targets. Staff can use data mining tools to gain visibility into audit exposure, along with reporting, detailed analysis and tracking tools to manage and streamline the audit process. In addition, a dashboard provides chief financial officers a consolidated view of all claims involved in the audit. Featuring subscription-based pricing and Web-based hosting, RAC Management is a comprehensive, cost-effective solution that offers insight and workflow support for staff at all levels of the organization.
“Based on the results of the RAC pilot program, there’s no question that RAC audits will pose a number of significant challenges to providers when it is expanded across the nation,†said Sheila Schweitzer, chairperson and CEO of CareMedic Systems. “In addition to the significant financial impact of take backs for overpayments to Medicare, organizations in the pilot states experienced the administrative disruptions of large volumes of data retrieval, responding to requests from auditors, and tracking the status of those requests and the individual accounts and records being reviewed. Based on our experience, hospitals will need a holistic solution that supports the entire RAC process continuum, from audit preparation, to audit workflow tools, to trending and analysis capabilities to help prevent new problems down the road. Our new solution empowers both frontline business staff and financial executives to address this pending impact to hospital regulatory compliance, cash flow, and administrative burdens.â€
CareMedic’s RAC Management includes predefined reporting and outbound file creation capabilities to enable providers to analyze historical claim data to assess financial exposure prior to a RAC audit. During an audit, strong workflow tools help the organization track medical record requests and RAC acknowledgement with minimum data entry. Dashboard reporting can be set to notify appropriate staff of impending deadlines. RAC Management’s tracking capabilities also will alert staff when CMS imposes an automated audit take back. In addition, dashboard views support pinpointing root causes of take backs to help mitigate future financial exposure and impact.
Current users of CareMedic’s MedicareRT can activate the RAC Management solution within days to seamlessly and quickly obtain information related to audit exposure based on historical claims. New users can leverage MedicareRT’s ASP-based platform to quickly adopt the solution with minimal disruption.
The RAC program, managed by the Centers for Medicare and Medicaid Services (CMS) is targeted to identify and recover improper or inaccurate Medicare fee-for-service payments. Following a three-year pilot program in California, Florida and New York from 2005 to 2008, the CMS program corrected more than $1 billion in Medicare improper payments, 95 percent of which were overpayments collected from providers. Once the program is rolled out to the remaining 47 states, all hospitals will be susceptible to RAC reviews. CMS auditors will review a provider’s historical Medicare claims to discover overpayments and underpayments, requiring business offices and others to potentially respond to thousands of medical record requests on a monthly basis during the review.
About CareMedic Systems
Founded in 1997, CareMedic Systems provides enabling technologies and outsourced services that move and manage critical data through the healthcare revenue cycle, ultimately improving cash flow and margins while reducing operational expenses. The company’s fully integrated data management and workflow tools address revenue cycle activity from inception through claims resolution, and require manual intervention only when necessary. CareMedic is committed to consistently delivering results to its customers. For additional information, visit www.caremedic.com.
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