360 Compliance Survey reveals serious problems in hospitals, the CMS RAC for controls

Compliance 360, a leading provider of Software-as-a-Service (SaaS) solutions for enterprise governance, risk and compliance (eGRC) and the most widely used solution in the healthcare industry, today announced the results of a recent survey of hospitals preparing for CMS RAC audits.

The survey of several hundred hospitals conducted in late 2008 found that “holding everyone accountable for their part of the RAC process” is their primary concern. Other top concerns from the survey included “managing the complexity of the appeals process”, “managing record requests and appeals across multiple locations”, and “gathering medical records in a timely fashion”.

“Based on the stringent deadlines specified for both record requests and each step of the appeals process, combined with the potential for the loss of legitimate revenues, these top concerns should come as no surprise,” said Steve McGraw, President and CEO of Compliance 360. “With the implementation of the RAC program back on track, hospitals need to move quickly with their preparations to address these concerns. During the automatic stay of the RAC program, we’ve been working with several dozen hospitals preparing for RAC audits and implementing the Compliance 360 Claims Auditor™ solution. We’ve observed challenges and requirements that are very consistent from one organization to the next and we’ve also seen that the Compliance 360 Claims Auditor can be a very effective solution for managing RAC audits to help minimize the loss of legitimate revenues.”

To learn more about the observed factors impacting the success of a claims audit solution, or to request an online demonstration of the Compliance 360 Claims Auditor, please click here or visit www.compliance360.com/RAC/RACsuccess.asp.

The Compliance 360 Claims Auditor helps healthcare providers manage a wide variety of claims audits including the Medicare Recovery Audit Contractor (RAC) audits, Medicare Program Safeguard Contractor (PSC) audits, Medicare Comprehensive Error Rate Testing (CERT) audits, Medicaid Integrity Contractor (MIC) audits, Medicaid Fraud Control Unit (MFCU) audits and other forms of claims audits.

Compliance 360 is the leading provider of enterprise governance, risk management and compliance solutions for healthcare providers. With these solutions, healthcare providers reduce risks, improve efficiencies and protect their brands using a single platform to address their comprehensive GRC requirements. The Compliance 360 solution for healthcare addresses the need for policy management, centralized regulatory management including HIPAA, Medicare, EMTALA, STARK and others, Joint Commission Accreditation, OIG corporate integrity agreements (CIA), False Claims Act (FCA) Compliance, adverse-event management, contract management, surveys, remediation projects, medical records audit management for Medicare CMS RAC audits, self assessments, and enterprise risk management. Industry leading healthcare providers that depend on Compliance 360 include Billings Clinic, Catholic Healthcare Systems, IASIS Healthcare, InterDent, Jackson Memorial Hospital, LifeLink Foundation, MultiCare Health System, Nassau University Medical Center, PeaceHealth, Saint Joseph’s Hospital of Atlanta, St. Elizabeth Medical Center, St. Luke’s Regional Medical Center and Spectrum Health.