Manage Denials, Underpayments, Pre-payment and Retrospective Claim Audits
Although audits and claims denials have always been facts of hospital life, new auditing agencies and ever-changing payor rules make it more difficult to respond adequately. Adding staff is not a likely scenario. So leading hospitals are turning to automated tools to manage the situation.
The solutions in Craneware's Audit & Revenue Recovery product family let you recover and preserve more reimbursement, using your current staff levels.
Craneware's Audit & Revenue Recovery product family:
- Manages claims denials from all payors, and uncovers the root causes of denials. Its automated workflow even distributes denied claims to appropriate staff.
- Manages all the details and deadlines of any RAC or other external audit, from one central location. And weighs likely outcomes and calculates dollars that you should put in reserve.
- Identifies underpayments by comparing 835 remittance data, line by line, to your payor contracts. Implementation of the product includes the upload of your managed-care contracts into the system.
Craneware’s Audit & Revenue Recovery family, which includes, InSight Denials®, InSight Audit®, and InSight Payment Variance Analyzer® are easy-to-master ASP solutions that manage denials and audits by all payors and all auditing agencies.