IVANS AuditDocs Reduces Administrative and Financial Burdens for Healthcare Providers By Automating the Submission Process for Medicare Audits

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IVANS Partners on CMS esMD Program to Eliminate Paper Processes

Clare DeNicola, president & CEO of IVANS, Inc., said, “Through our partnership on esMD, we are extending our healthcare transactions on IVANS HIE platform by providing a secure, electronic process that replaces costly & time-consuming methods."

IVANS AuditDocs(SM) Reduces Administrative and Financial Burdens for Healthcare Providers By Automating the Submission Process for Medicare Audits

IVANS Partners on CMS esMD Program to Eliminate Paper Processes

IVANS, Inc. a national health information exchange, announced today a new solution called IVANS AuditDocs(SM) to save healthcare providers time and money during Medicare audits. AuditDocs enables providers to quickly and securely submit medical documentation electronically for audits initiated by the Centers for Medicare and Medicaid Services (CMS) under the Electronic Submission of Medical Documentation (esMD) program.

Recognizing the need to provide a more efficient way to deliver medical records to the review contractor, the esMD Program enables Medicare auditors, including RACs (Recovery Audit Contractors), MACs (Medicare Administrative Contractors), CERT (Comprehensive Error Rate Testing), PERM (Payment Error Rate Measurement) and ZPICs (Zone Program Integrity Contractors), to accept electronic attachments from providers. Healthcare professionals generally fax or send paper to substantiate Medicare audits today. Under the esMD Program, providers can work with a CMS-approved Health Information Handler (HIH), such as IVANS, which has developed a CONNECT-compatible gateway that conforms to Nationwide Health Information Network (NHIN) standards and leverages IVANS health information exchange (HIE) platform.

Clare DeNicola, president and CEO of IVANS, Inc., said, “For years, we have worked closely with CMS to enable 500,000 providers secure, affordable access to Medicare for claims processing. Now through our partnership on the esMD program, we are extending the support of our healthcare transactions on IVANS LIME™ HIE platform by providing a secure, electronic submission process that replaces costly and time-consuming methods.”

When a healthcare provider is notified of an audit, the provider has 45 days to submit medical records to substantiate the Medicare claim. Through IVANS AuditDocs, providers can send documents to review contractors electronically in real-time instead of printing, packaging and shipping thousands of pages of medical documentation to support their claims. AuditDocs also supports a robust dashboard for detailed tracking, so providers can monitor which documents have been sent and when they are received by the auditor. The solution includes document archiving to ensure documentation is readily available throughout the appeals process.

IVANS recently conducted a hospital survey which revealed that 73 percent of hospitals agree that the Recovery Audit Contractor (RAC) Program helps to reduce fraud and errors in the industry. However, more than 60 percent do not think the audit process is fair. According to IVANS 2011 RAC Audit Survey, respondents cited that the extra time and money it takes to substantiate a RAC claim is impacting budgets and resources that are already stretched too thin, and that the frequency (every 45 days) with which they can be audited is burdensome to their administrative workflow. The study also found 32 percent of hospitals surveyed have put tracking software in place, 21 percent have hired additional staff or external resources to respond to RAC audits, and 38 percent have modified claims admission criteria to reduce future denials.

DeNicola said, “Many of our customers, including hospitals, DMEs, and home health and skilled nursing facilities, are concerned with the time and financial impact required to meet tight deadlines. As the CMS esMD initiative gets underway this month, I am confident that providers will not only enjoy this faster, less expensive method for responding to payment audits, but the healthcare industry will embrace this program as an important step toward advancing the adoption of interoperable health IT systems and health information exchanges across the country.”

IVANS Inc. provides the property and casualty insurance and healthcare industries with fully managed network, electronic data interchange (EDI) and agency-company interface solutions to help solve complex business issues. Headquartered in Stamford, Conn. and a CMS approved vendor, IVANS serves over 4,400 insurance and healthcare organizations, more than 30,000 independent agents and 500,000 healthcare providers. With over 25 years of experience successfully managing networks, the company also offers its clients relentless customer service, security solutions, reliable and accessible technical helpdesk support and expert enablement. IVANS, which was formed by 21 insurance companies, also has offices in Tampa, Fla. and Cincinnati, Ohio. For information, visit http://www.ivans.com/auditdocs. Visit IVANS healthcare blog, HealthWire, at http://www.ivans.com/healthblog.

Cecile M. Locurto


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