Streamline audits from government and commercial payors
Are you facing denials from auditors? Whether your hospital or health system is seeing increases in commercial audits, Medicaid audits, or Medicare audits like RAC, Craneware’s InSight Audit allows you to quickly respond to all audit types and centrally manage your audits from chart request through to the final levels of appeals.
Discover visibility into your commercial and government audits by aggregating your audit data and seeing the bigger picture
- Have a clear view into what revenue is at risk due to audits and where in the appeal process your money is.
- Measure audit KPIs like appeal percentages and overturn rates. Integrate audit case notes into your hospital or health system’s billing system.
Convert time wasted on manually processing your case workload into time invested in protecting your hospital or health system’s margin
- Automated data entry – respond to hundreds of medical record requests quickly and efficiently.
- Track all payor audits and share audit documentation from a single location.
- No more printing – submit your documentation and appeals electronically with esMD.
- Scalable workflow and automatic identification of deadlines – work smarter whether you’re one person or a team of 50.
Optimize your audit management program
- Accurately project your needed revenue reserves and audit risk.
- Understand what appeal strategies are most effective.
- Identify your top recurring audit issues by DRG and CPT.
- View productivity of staff and effectiveness of appeals.
Appeals Services
Appealing improper denials is an important step in protecting your hospital or health system’s margin. Our Appeal Services consultants have been at the front-lines of audit management since the early days of the recovery audit demonstration phase: their real-world experience with managing the RACs is why we created InSight Audit in the first place.
Craneware has the experienced staff you need to review your denials, write successful appeals, and overturn improper denials. When a denial review results in a recommendation not to appeal, written guidance is provided back to the hospital or health system to help prevent the same denials from recurring.