CONCERNED ABOUT CURRENT OR FUTURE AUDITS?
The Recovery Audit Contractor (RAC) Program was authorised by the US Congress to identify improper Medicare payments (overpayments and underpayments). The Centers for Medicare & Medicaid Services (CMS) named four permanent Medicare Recovery Audit Contractors (RACs) as part of the nationwide program rollout. These contractors identify improper Medicare payments and receive a contingency fee based on a percentage of the improper payments they identify and collect.
The permanent RAC program allows claims to be audited for the following provider types: hospital inpatient and outpatient, long-term care hospitals, inpatient rehabilitation and psychiatric hospitals, critical access hospitals, skilled nursing facilities, physician, ambulance, laboratory, home health, hospice and durable medical equipment. Recovery Audit Contractors can review claims back to October 1, 2007.
This program requires a facility to assign scarce resources to critical tasks required to analyse and respond to RAC requests and develop tracking and appeal processes to protect revenues. Exela assembled a team of internal and external experts to develop a suite of services to help our clients manage through the process and develop both business and legal appeal strategies.
The result was Exela RACSource, a financial management and appeals analysis tool. This state-of-the-art SaaS offering was developed leveraging Exela's extensive experience in denial management, coding and compliance auditing. Its efficient workflow, extensive and customisable reporting, and real time dashboards provide unprecedented efficiency in dealing with this critical process. More than a tracking tool, Exela RACSource is a comprehensive software and analytic solution providing real-time, ongoing prompts, reminders and alerts that ensure timelines and deadlines are always adhered to and never missed. More importantly, RACSource provides detailed client-specific analysis of the ongoing vulnerabilities of your site to RAC denials, and it identifies the documentation and process solutions that should be implemented to eliminate the weakness and prevent the denial months before the RAC identifies it.
Exela’s fees are a fixed monthly fee.
Exela’s Audit Track services were initially designed for RAC and named RACSource. This service now incorporates additional governmental audit types including CERT, MAC, MIC, ZPIC.
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