With as little as 30-45 days to respond to Medicare audit requests for fee for service patients, hospitals frequently end up ‘behind the eight ball’ when it comes to timely filing. Money is often left on the table due to an inability to respond to requests that have been lost in transit or delayed. To combat this challenge and eliminate the need to manage, mail or fax paper documents, the Centers for Medicare & Medicaid Services (CMS) launched the Electronic Submission of Medical Documentation (esMD) initiative in 2011. Yet a decade later, many healthcare systems are still physically mailing audit responses, wasting time and losing money along the way.

As RAC audits pick up steam, your teams can be prepared to electronically receive and respond to CMS audit requests with the new Refyne platform. Review our Medicare Audit Survival Guide e-book for tips on managing your RAC audit processes.

Small tweaks to process changes can yield big dividends

Vyne Medical understands the financial battles being fought by hospitals and health systems as they strive to provide the best possible patient care in a manner that’s fiscally responsible. Eliminating the administrative burdens associated with tracking, managing and fulfilling audit requests in a timely manner is one way we can help. That’s why we’re excited to introduce the Refyne platform featuring Refyne Audits.

Cloud-based technology enables timely filing of Medicare audit responses and appeals
across the enterprise.

Ditch the paper and the screen scraper for a single, unified workflow

The Refyne platform, featuring Refyne Audits, is a cloud-based, software as a service (SaaS) solution that uses esMD to enable electronic transmission of request and response data between hospitals and CMS in a protected environment. The Refyne Audits solution empowers providers with a fully electronic workflow for managing Medicare audits, Medicare audit process, and reducing associated claims denials. Communications for Additional Documentation Requests (ADRs) including Medicare pre- and post-payment audits, level one and two appeals, and Advanced Determination of Medicare Coverage (ADMC)  are enhanced via the Refyne web portal and integrated application programming interface (API) solution. In short, Refyne helps to streamline what were formerly multiple, disjointed processes into a single, seamless, automated workflow.

With Refyne Audits, you can:

• Simplify and automate government audit workflows
• Receive and respond to Medicare medical documentation requests electronically
• Help eliminate “lost” audit notifications and ADRs sent by mail – saving time and money
• Prove timely filing with receipts showing when audit responses were received by CMS and the audit contractors
• Demonstrate appropriate levels of care and have confidence that you will get reimbursed for services provided
• Improve payment response times for audited claims
• Manage audits through a single, cloud-based solution with 24/7 access from wherever your office may be – remote or on-site
• Consolidate software tools eliminating the need for separate data/screen scraping utilities
• Enhance the security of audit response data with electronic delivery in a protected environment