Revenue Integrity Company to Provide Healthcare Organizations with Mechanism for Submitting Medical Documentation Electronically; Supports CMS Goals for Streamlined, Efficient Electronic Communications
ATLANTA, August 28, 2012 – Craneware, Inc., the market leader in automated revenue integrity solutions, today announced that it has achieved Electronic Submission of Medical Documentation (esMD) certification from the Centers for Medicare and Medicaid Services (CMS.) With this certification, Craneware is now authorized to offer esMD gateway services to provider organizations to enable the electronic submission of medical records to review contractors.
As one of a small number of certified esMD vendors, Craneware was certified based on its participation in the esMD Gateway Services pilot program. To facilitate the adoption of streamlined processes amidst increasing healthcare audits, including the recently announced RAC Prepayment Review Demonstration phase that focuses on specific types of claims with historically high improper payment rates, Craneware will provide a mechanism for the digital exchange of medical record documentation.
Craneware will enable its InSight Audit™ solution to digitally submit medical record documentation as an esMD-certified Health Information Handler (HIH). This capability will increase efficiency of the audit process and assist hospitals and health networks with the collection and retention of earned revenue to improve the efficiency of audit defense, including Medicare Recovery Audits (formerly RAC) and Medicare Administrative Contractor (MAC) audits. In phase two of the esMD program, which will begin in 2013, review contractors will also be able to electronically send Additional Documentation Requests (ADR) to providers via approved HIH vendors.
“CMS’ esMD program increases the efficiencies around documentation requests to ensure improper payments are handled as quickly as possible,” said Craneware CEO, Keith Neilson. “Since the early days of the RAC demonstration project, Craneware’s InSight Audit Knowledgebase has grown and now, in becoming an esMD-certified vendor, we’ve expanded the capabilities of our Audit and Revenue Recovery solutions to support our clients’ document submission needs with CMS. As a certified esMD provider, we help clients’ efficiently comply with documentation requests and support CMS in its goal to transform electronic communications via these gateways, particularly as esMD promises to become the future of audit tracking.”
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. Craneware’s InSight Audit Knowledgebase contains the latest information on best practices and payment rules, providing valuable audit-specific content that includes templates, checklists, and request forms.
Craneware Revenue Integrity Solutions® span four product families: Audit & Revenue Recovery, Revenue Cycle, Supply Management, and Access Management & Strategic Pricing. Craneware developed the industry’s first chargemaster management solution, Craneware’s Chargemaster Toolkit® has ranked number one in the KLAS Revenue Cycle – Chargemaster Management market category for the past six years. In 2011 Craneware’s Bill Analyzer achieved number one ranking in the KLAS Revenue Cycle – Other market category.
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.
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