Recovery Audit Contractor (RAC) Audits
Many hospitals want to get out in front of the ongoing expansion of the permanent RAC (Recovery Audit Contractor) program by CMS;
however, they may not have the resources to determine whether their systems are ready.
OCExaminer's analyzes both your inpatient and outpatient claims to
help you identify any claims that contain potential RAC issues.
These alerts can be used to determine possible claim errors on the front end, allowing any necessary corrections to be made before the
claims are processed.
Our RAC Audits include
- Invalid Units of Blood Administration
- Inpatient One-Day Stays
- Debridement
- Present on Admission
- Medical Necessity
Faster Submissions
OCExaminer delivers a combination punch of efficiency by providing
more comprehensive analysis and including the functionality to
submit
edited claims straight to the clearinghouse for processing.
You'll save time and money by submitting electronically instead of
printing bills. Most importantly, you'll get paid faster!
Interface or Integration - Either Way, It's Included
We want you to receive the full benefit of implementing OCExaminer
so we'll gladly assist you in updating your patient accounting
system. Whether you simply want a file-transfer interface or a more complex data-to-data integration, we'll work with your staff to
develop the
solution you need.
Give Your Team the Power Tools They Need
OCExaminer evaluates all edits simultaneously every time you submit your claims. Other scrubbers stop evaluating claims after
finding an initial issue
and force your staff to correct and then resubmit their claims again and again. This slows down the
submission process, which slows your cash flow.
Edit Report
With OCExaminer, your staff can see all issues identified after each analysis of their claims. This is a much more efficient process that significantly reduces the time between scrubbing and submission.
Claim Demographics
Your staff won't need a lot of training either, because OCExaminer's interface was designed to keep things simple. Claim information is displayed in the familiar UB style providing a preview of the bill prior to submission to the clearinghouse.
Services
We even designed the line item editor to look just like a UB, so you know exactly how the bill will look with your changes.
OCExaminer provides a simple dashboard interface that makes it easy for you to get answers and to share the results with your staff. You also have the ability to turn edits on or off as you choose, sort and group according to your needs, and even create your own edits using our robust User-Defined Edits module.
Also, the tool is entirely web based, so you have nothing to install or maintain. Our staff works behind the scenes to include
any changes from CMS
prior to their implementation.
Since there is no I.T. involvement you can implement and use OCExaminer almost immediately.
Concurrent Review
OCExaminer identifies an 8% to 15% error rate on scrubbed claims. These are not insignificant edits designed to trigger alerts. These
errors are for CMS edits that will either result in a rejection or denial - and delay you from getting paid.
We know that every hospital has a claims scrubbing software product under contract. Other scrubbers stop evaluating claims after finding
an initial issue. OCExaminer identifies and reports all problems at once.
This is a much more efficient process that significantly
reduces the time between scrubbing and submission.
OCExaminer is immediately justifiable to your organization because it allows you to establish a concurrent review program without adding
FTEs or burdening your staff.
Superior Value
Our belief is that hospitals typically don't receive the revenues that they are entitled to because of the complexities in the business of healthcare. We have recovered millions of dollars of lost charges through our consulting services, and have priced our technology solutions to make your investment decisions simple.
We have a multiple tier pricing structure to accomodate your facility's needs. Contact Us now to discuss the best package for you.
So whether you are trying to maximize revenues and cash flow, implementing a concurrent review program, or considering replacing
your current claim scrubbing system; OCExaminer is immediately justifiable to your organization.