Manage Medicare Audits with Electronic Documentation Submissions

Simplify the process of receiving and responding to audit requests from the Centers for Medicare & Medicaid Services (CMS) with the Refyne platform

Hospitals and health systems consistently face the daunting task of receiving and responding to CMS Medicare Fee-for-Service (FFS) Recovery Audits as part of the normal course of business. Most often, audit responses like these involve a complex series of manual, paper-consumptive processes. These labor-intensive, non-trackable exchanges create issues with staff productivity while also posing challenges with revenue and reimbursement, as untimely submissions can lead to a greater likelihood of denied claims.

The Refyne™ platform featuring Refyne Audits is a fully electronic, cloud-based solution for document submission that improves the Medicare audit response process for hospitals and enables providers to receive Additional Documentation Requests (ADRs) via Electronic Medical Documentation Requests (eMDRs) and submit documents in a timely, trackable manner.

Healthcare organizations using the Refyne platform can also participate in the CMS Electronic Submission of Medical Documentation (esMD) initiative and help ensure timely, accurate reimbursement for the care they provide.

Opportunities for organizations using Refyne include:

  • Decrease denials by enabling quick, electronic responses to time sensitive Recovery Audit Contract (RAC) and other Medicare audits
  • Eliminate untimely record submissions and rework requests
  • Enhance tracking of responses with an electronic audit trail that includes date and time stamps
  • Reduce costs associated with manual printing and mailing of documentation
  • Enhance the security of response data and help ensure that protected health information (PHI) required for claims submission and coordination of care is electronically transferable and available in a compliant, electronic format
  • Exchange documentation with existing healthcare information technology (HIT) solutions via Application Programming Interface (API) for easy access to requested patient information
  • Manage audit requests from anywhere with 24/7 online accessibility

Improve Medicare claim reimbursement times with esMD

According to CMS, providers using esMD can expect reimbursement for claims within 3-5 days versus 3-4 weeks if documents are mailed for processing

Decrease denials with a single, unified workflow for audit management

Eliminate discrepancies that can arise using multiple systems to manage audits. Refyne easily integrates with other HIT solutions via API to provide seamless document exchange

Empower audit response teams to work remotely

24/7 access to the cloud-based Refyne platform delivers simplified digital workflows that enable teams to work from anywhere and eliminates the need to print and mail hundreds of pages of documentation

Find out how using the Refyne platform to streamline your Medicare audit management processes could improve your response and reimbursement times.

Contact us to schedule a call with one of our Vyne Medical healthcare solution experts today