Revenue Integrity Solutions Provider Announces Participation in CMS Initiative to Improve Efficiency of Claims Audits
ATLANTA, Feb. 27, 2012 /PRNewswire/ -- Craneware, Inc., the market leader in automated revenue integrity solutions, today announced its participation in the Centers for Medicare & Medicaid Services' (CMS) electronic submission of medical documentation (esMD) Gateway Services pilot program. The program provides a mechanism for the digital exchange of medical record documentation in order to streamline and improve the efficiency of audit appeals, including Medicare Recovery Audit (formerly RAC) audits and Medicare Administrative Contractor (MAC) audits.
Current medical record submission processes, coupled with CMS' forecast of an increased number of audits in 2012, represent a significant challenge for healthcare organizations. Currently, in order to support Additional Documentation Requests (ADR) for Medicare audits, providers must manually submit compact discs, DVDs, or paper-based documentation for review — a costly and time-consuming process. By participating in the esMD pilot program, Craneware will enable its InSight Audit™ solution to digitally submit medical record documentation. This updated capability will increase efficiency of the audit process and assist hospitals and health networks with the collection and retention of earned revenue.
"A significant source of healthcare revenue leakage for providers today is the use of inefficient processes, such as the current antiquated method of paper-based documentation requests, which are a huge administrative burden and should be easily remedied with technology," said Craneware CEO, Keith Neilson. "By participating in the esMD pilot program, Craneware will expand the capabilities of our Audit & Revenue Recovery solutions to support the efficient and streamlined electronic submission of medical documentation, helping ease the strain of yet another financial burden facing U.S. healthcare providers."
Craneware's InSight Audit is a fully hosted, Web-based solution that provides healthcare organizations with one central location for managing all medical claims audits. The solution offers a full set of features for submitting, tracking and appealing claims in response to a range of audits, including Medicare Recovery Audits, MAC audits, and commercial payor audits. When CMS gives the go-ahead to the current group of pilot vendors, now scheduled for late this quarter, InSight Audit will support electronic exchange of medical documentation to allow hospitals to respond to documentation requests with greater efficiency and less cost.
One quarter of registered U.S. hospitals use Craneware Revenue Integrity Solutions™. In 1999, Craneware introduced the industry's first effective chargemaster management solution. Today, Craneware's flagship product, Chargemaster Toolkit® has achieved HFMA Peer-Review status for eight consecutive years and for the last six years, Chargemaster Toolkit® is ranked first in the Revenue Cycle – Chargemaster Management market category in the "2011 Best in KLAS Awards: Software & Services" report, published December 2011.
Craneware (AIM: CRW.L) is the leader in automated revenue integrity solutions that improve financial performance for healthcare organizations. Craneware's market-driven, SaaS solutions help hospitals and other healthcare providers more effectively price, charge, code and retain earned revenue for patient care services and supplies. This optimizes reimbursement, increases operational efficiency and minimizes compliance risk. By partnering with Craneware, clients achieve the visibility required to identify, address and prevent revenue leakage. To learn more, visit craneware.com and stoptheleakage.com.
SOURCE Craneware, Inc.