CareMedic Systems, Inc., the industry leader and largest provider of real-time Medicare transaction processing, today announced that Cleveland Clinic is among many prominent healthcare organizations to choose its Audit Management solution for RAC. With this Web-based solution, providers can identify root causes, measure potential exposure, track the RAC process and manage the exceptions.
“We performed an extensive review of the systems currently available to support RAC,” states Lyman Sornberger, Cleveland Clinic’s executive director of patient financial services. “We concluded that the CareMedic tool allowed us the ability to manage the process flow of multiple hospitals with ease, provided financial reporting necessary to understand and clearly articulate our risk, and functionality to implement process improvements with the data and reporting capabilities available. The team at CareMedic understood RAC, which gave us confidence that the tool was going to have the functionality we needed to support this new initiative with as much automation and tracking as possible in a cost effective way.”
A few of the additional organizations choosing CareMedic’s solution include Iowa Health System, Bethesda Healthcare, Samaritan Health Services, Sharp Healthcare, MaineGeneral Medical Center and University of Maryland Medical System.
Sheila Schweitzer, CareMedic chairperson and CEO, explains the company’s approach to developing a RAC audit solution. “Audit Management is a logical outgrowth of our extensive background in real-time Medicare connectivity and compliance. We already had the fundamental components available through MedicareRT, our workflow and tracking technologies and our integrated performance management dashboard capability. Combining those proven technologies allows us to provide a powerful solution that helps organizations of every size minimize the labor required to manage, track and analyze audit and appeal activity.”
In 2008, the company developed Audit Management in response to the CMS rollout of the Recovery Audit Contractor (RAC) program. Under the RAC program, independent contractors perform both automated and complex audits of historical paid Medicare claims to identify overpayments, which are then “taken back” by CMS. Audit Management not only assists in tracking record requests, deadlines and appeals, but identifies potential risk and includes RAC-specific edits to prevent future problems.