Program Extended Due to Popularity with Healthcare Providers and CMS Initiatives to Expand RAC Audit and Revenue Recovery Programs for Medicare and Medicaid in 2011
ATLANTA--(BUSINESS WIRE)-- Compliance 360, a leading provider of Software-as-a-Service (SaaS) solutions for enterprise governance, risk management and compliance (eGRC) today announced that its popular “Cash-for-Clunkers” trade-in program for healthcare providers has been extended until May 31, 2011. The program provides discounts to healthcare providers that initially invested in low-end, limited-functionality software applications for managing overpayment recovery audits including Medicare and Medicaid Recovery Audit Contractor (RAC) Audits and Medicaid Integrity Contractor (MIC) audits.
Congress and the President expect the recovery of Medicare and Medicaid overpayments to fund many of the new healthcare programs. The goal is a reduction in improper payments of at least 50% by 2012. In support of these lofty goals, provider reimbursements will come under increasing scrutiny as the current recovery audit programs expand in 2011 to include:
- RAC for Medicaid, in addition to the current Medicaid Integrity Contractor (MIC) audit program
- RAC program expansion to include Medicare parts C and D
“As the anticipated risks of RAC and MIC audits became a reality in 2009 and 2010, many healthcare providers made hasty software selections and are now learning that their software, with limited flexibility, is providing only minimal revenue protection,” said John Brooke, General Manager of Healthcare for Compliance 360. “As the revenue recovery audits increase in 2011, these limitations are likely to become even more pronounced.”
The Compliance 360 Claims Auditor, licensed for use in over 900 healthcare facilities nationwide, is proven to help healthcare providers take control of medical claims audits and appeals, and protect their legitimate revenues from being caught up in the recoupment of overpayments. With advanced workflow, healthcare providers can manage the complexity of multiple, simultaneous recovery audits to ensure that due dates are not missed. Serving as the “Virtual Audit Coordinator”, the Claims Auditor automatically manages each step in the response and appeals process, allowing key personnel to concentrate on high-risk areas and monitor the overall program. The Claims Auditor also serves as the claims audit system of record, enabling healthcare providers to establish a common point of control for managing all claims audits including RAC, MIC, MAC, CERT, PERM, ZPIC and commercial payor audits.
“In response to the expanded audit programs planned for 2011 as well as requests from providers across the country, we are happy to extend our Cash for Clunkers program,” added Brooke. “Under the proposed regulations for expanded audits, States may use their current administrative appeals process or may modify the process for Medicaid RAC appeals. Adapting to these yet-to-be–published appeals processes, that will vary from state-to-state, will create a new set of challenges for providers and especially for those using software solutions with limited flexibility. Fortunately with Compliance 360, providers can easily adjust as appeals processes are changed by simply tuning the workflow to match the process.”
Healthcare providers interested in taking advantage of the “Cash-for-Clunkers” trade-in program, should contact Compliance 360 at [email protected] or (678)992-0262. The program is currently scheduled to run through May 31, 2011.
About Compliance 360 for Healthcare
Compliance 360 is the leading provider of enterprise governance, risk management, compliance and audit management solutions for healthcare providers. With these solutions, healthcare providers reduce risks, improve efficiencies and protect their brands using a single platform to address their comprehensive GRC requirements. The Compliance 360 solution for healthcare addresses the need for policy management, centralized regulatory management including HITECH, HIPAA, EMTALA, STARK and others, Joint Commission Accreditation, OIG corporate integrity agreements (CIA), False Claims Act (FCA) Compliance, adverse-event management, contract management, surveys, remediation projects, claims audits and denials, Medicare RAC audits, Medicaid MIC Audits, self assessments, internal audits, and enterprise risk management. Over 150,000 active users rely on Compliance 360 everyday to manage their risk, audit and compliance programs. To learn more about the Compliance 360 solution for healthcare, visit www.compliance360.com/healthcare.
Editor’s Note: Compliance 360 is a registered trademark of Compliance 360, Inc. Virtual Evidence Room is a registered service mark of Compliance 360, Inc. Any other trademarks are recognized as proprietary to their owners.
Scot McLeod, 678-992-0262
Vice President, Marketing
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