HomeTown Health's Business Partner, Quadax, Equips Providers for Newly Established Medicaid RAC Audits

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Decreasing the Burden on Healthcare Providers To Defend Reimbursements

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HomeTown Health & Quadax pursue ways to help its members survive in this environment of constant change in reimbursement, operations and technology.

On September 16, 2011, The Centers for Medicare and Medicaid Services published the Final Rule to establish the Medicaid Recovery Audit Contractors (RAC) program. HomeTown Health's new Medicare’s RAC program is serving as the template for this new initiative, estimated to save taxpayers $2.1 billion over five years, with $900 million being returned to states.

Adding to the alphabet soup of audits faced by hospitals and other healthcare providers, the Medicaid RAC initiative will increase the burden on healthcare providers to defend their reimbursement by producing documentation within restricted timeframes.

The Audit ControlX suite of services from Quadax equips healthcare providers to handle every type of audit with which they are presented. Multiple audits, one Audit ControlX system. Within the Audit ControlX suite are components that may be used individually or in combination to meet the specific needs of any healthcare organization, including a hosted application for audit case management, hands-on appeals management by an experienced staff, enhanced claim editing for RAC-specific issues, and data mining for risk evaluation.

Axis™ is the powerful and flexible application for managing every challenge to a provider’s reimbursement. Axis is the perfect complement to Xpeditor, Quadax’s electronic transaction management engine, as Axis will draw on Xpeditor to pull the historical claim and remittance data required for defense or appeal, workflow each case as appropriate and flag with important dates so that deadlines are not missed. Comprehensive reporting has value for every level of the organization, and generates AHA RACTrac Survey data for submission to the American Hospital Association.

The appeals functionality of Axis also complements Xpeditor’s Denial ManagementX Workflow module, permitting appeal letters based on a provider’s custom templates to be generated in order to recover dollars inappropriately denied by any payer.

Xpeditor, engineered by Quadax, is the browser-based system available for either an Enterprise on-site installation, or hosted by Quadax (SaaS). At its heart is a powerful, user-friendly transaction management system for claims, with Xtensions for Remittance ManagementX, Denial ManagementX, and management of other HIPAA-standard transactions, plus Audit ControlX. Innovative strategies and superior technology are evident throughout the Xpeditor Xtensions system; unparalleled relational service rounds out the Quadax EDI experience, assisting providers to achieve excellence in the healthcare business office.

Since Quadax became a HomeTown Health business partner in October of 2009, approximately 20 member hospitals have put their confidence in Quadax to take their business office to the next level. One of those is Taylor Regional Hospital in Hawkinsville. Deana Floyd, Director of Patient Financial Services at Taylor Regional Hospital, sees firsthand the value of that relational service, saying “In over 20 years in healthcare I’ve never seen a company provide as much training and education as Quadax. It’s really nice to see that you continue to come on-site until all of our billers and management feel completely comfortable with the product.”

The Quadax mission, to improve the financial performance of organizations in the healthcare industry by creating efficiencies in their revenue cycle with innovative strategies, products, and services built on superior technologies, and by delivering relational service with integrity and dedication, fully supports the HomeTown Health mission to “pursue ways to help its members survive in this environment of constant change in reimbursement, operations and technology.” Together, HomeTown Health and business partner Quadax are making a difference in the viability of rural healthcare in the state of Georgia.

HomeTown Health, LLC is an organization of rural and small hospitals, located throughout the state of Georgia, who collectively pursue ways to help these hospitals survive in this environment of tremendous budget cuts from the state and federal level. What began as a handful of community hospitals eleven years ago, has now grown into an organization of 55 hospital members and over 50 business partners.

Visit http://www.hometownhealthonline.com or http://www.quadax.com/ for more information.

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Brooke Fritz
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