Dramatic Increase in Recovery Auditor Take-Backs; Craneware Predicts Continued Escalation of Payment Recoupment and Compliance Focus
ATLANTA, April 10, 2012 – CMS’ Medicare Fee-for-Service Recovery Audit Program is accelerating exponentially. From Oct. 2011 through Dec. 2011, CMS’ Recovery Audit National Program (formerly RAC program) has already collected $397.8 million in overpayment take-backs from provider organizations: close to half of the total amount recovered in all of CMS’ fiscal year (FY) 2011 (Oct. 2010–Sept. 2011) during which Recovery Auditors collected $797.4 million in overpayment take-backs. And that figure is more than ten times the $75.4 million in overpayment recoveries in FY 2010 (Oct. 2009–Sept. 2010). With this staggering escalation of take-backs from 2010 to 2012, Craneware, Inc., the market leader in automated revenue integrity solutions, forecasts greater emphasis on compliance in healthcare. In response to the growing demand for information, best practices and tools to help provider organizations support compliance and manage audits, healthcare industry associations have invited Craneware to share information at audit and compliance events this spring.
“As Recovery Auditors escalate their reviews across healthcare organizations of all sizes, these audits are greatly impacting financial performance, driving the need for providers to ensure revenue integrity,” said Keith Neilson, CEO of Craneware. “Now more than ever, the entire healthcare industry is looking to adopt methodologies and processes that ensure charge compliance and reduce payment recoupment. As such, Craneware is sharing at upcoming conferences our real-world experiences, proven tools and best practices that help healthcare organizations effectively manage audits and compliance.”
At the American Association of Medical Audit Specialists (AAMAS) 18th Annual conference, Craneware Senior Vice President, Karen Bowden and Senior Data Products Manager Bill Malm ND, RN, CMAS and Healthcare Consultant Joan Hoover will lead five “Educational Workshops” focused on audits, and conduct three “Breakout Sessions” on compliance-related issues. The two-day specialty-focused audit course will leave participants well-versed and current in all aspects of audit with respect to all types of payors. By understanding the risks that healthcare organizations face today, auditors can act as solution agents, identifying where the problems that cause revenue leakage reside and how to solve those problems. The conference will be held April 10-13, 2012 at the Point Hilton Squaw Peak Resort in Phoenix.
In addition, Craneware will exhibit at the Health Care Compliance Association (HCCA) 16th Annual Institute from April 29 through May 2 in Las Vegas in booth 100, demonstrating software that works to enable optimal workflow and decision support for ensuring charge compliance, managing audits and preventing revenue leakage.
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 effective chargemaster management solution, and 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. More than a quarter of all registered U.S. hospitals use Craneware software.
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.
AAMAS provides resources and support to advance the practice of medical audit. AAMAS promotes a culture of professionalism that upholds the principles of integrity, the promotion of competency, legislative and regulatory compliance, and the personal and professional standards of conduct of the medical audit specialist.
HCCA currently has over 7,500 members and over 2,700 CHC certified in the U.S. HCCA exists to champion ethical practice and compliance standards and to provide the necessary resources for ethics and compliance professionals and others who share these principles.
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