Analytics - Recovery Audit Contractors (RAC) Audit Risk Analysis

 

 

The first step in managing claims affected by RAC audits is to identify them. This process is simple when you make RAC Analyzer part of your response process.

Prevalent "RAC Analyzer" is designed specifically for tracking and reporting RAC audit claims. RAC Analyzer can provide automated reporting to show you when a claim is affected by a RAC auditor. It can also separate claims by work model to show you exactly how the RAC audit is influencing your cash flow.

 

When you need to appeal a decision by a RAC auditor, our appeals tool, Maven, strengthens your strategy. Maven automatically analyzes denied claims, providing workflow solutions, appealing denials and offering ad hoc and comprehensive automated reporting. RAC claims are also managed in their own audit bucket for optimal tracking.

 

Once you receive a RAC audit determination letter, Maven can direct the workflow according to the outcome (whether favorable or unfavorable). It produces reports designed for management, audit trail and trending purposes.

RAC Analyzer’s reporting features offer automated reporting that tracks all your RAC audit claims, while also managing workflow for your staff. With RAC Analyzer and Maven, your facility gets a complete solution for keeping up your cash flow and tracking the cost and time your facility incurs due to RAC audits.

Inadequate and fragmented A/R processes result in less timely collections, lower revenue and higher risk for audit. Health systems need the expertise, best practice processes and tools to enhance compliance and validate payment accuracy from all payor types. 

Facing an audit is always a daunting task, and healthcare organizations continue to face complex reviews and audits not only by the Centers for Medicare & Medicaid Services (CMS) Recovery Audit Contractor (RAC) program and state agencies but also by commercial payors. In addition, many providers expect the transition to ICD-10 and its new level of coding complexity will trigger more audits as payors and health systems alike learn to navigate the new code set.

RAC Analyzer Features

  • Identify RAC audit risks and potential compliance violations
    • Take action quickly and avoid compliance violations.
  • Immediately correct the cause of violations
    • You get automated reporting that shows you exactly what caused your compliance violations. Correct your procedures and avoid making the same mistakes in the future.
  • Identify areas of weakness
    • Once you’ve identified the causes of compliance violations, RAC Analyzer can be used to manage your entire workflow.
  • Develop a comprehensive plan to prevent further violations
    • RAC Analyzer gives you all the necessary information for each step of the process.

 

 

 

 

 

 

Prevalent, Inc. a subsidiary of Axcension, Inc.

For more information or to see a demo of our product please contact us today.

14090 Southwest Freeway, Suite 300, Sugar Land, Texas 77478    l    (832) 413-5990  contactus (@) prevalenthealth.com

 

 
 
   

 

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