Electronic Health Reporter

As payers step up efforts to identify and recoup improper payments, hospitals and health systems require innovative solutions to mitigate the potential threat these reviews pose to the bottom line. To meet this need, Hayes, a leading healthcare technology provider that partners with the nation’s premier healthcare organizations to improve revenue, mitigate risk and reduce operating costs, has launched External Audit Workflow to streamline management of external audit responses.

“The volume of external audits is rising exponentially as the Centers for Medicare and Medicaid Services and other payers search for every dollar they can recover from over-coded or otherwise improperly filed claims,” said Peter Butler, president and CEO, Hayes. “To protect their hard-earned revenues and reputations, healthcare organizations need a strong first line of defense – an external audit management process that is collaborative, efficient, and comprehensive. That is Hayes’ goal with the launch of MDaudit Enterprise External Audit Workflow.”

MDaudit Enterprise External Audit Workflow simplifies and automates time-consuming and inefficient manual processes for tracking third-party audit requests, including commercial payers, Recovery Audit Contractors (RAC), Targeted Probe and Educate (TPE), and Comprehensive Error Rate Testing (CERT). Its flexible process templates and reporting tools deliver operational efficiencies and insights on potential risks and provide a consistent and repeatable audit response process.

With External Audit Workflow, hospitals and health systems gain access to tools that bring together all their external audit management activities into a secure HIPAA-compliant SaaS-based platform.

The three major tools that enable external audit management include:

Workflow: Using standard or custom workflow templates, organizations can streamline the creation and management of a single trackable audit and monitor progress and results through ad-hoc and management reporting capabilities.

Task management: Simplify coordination and tracking with customizable and curated sets of tasks that can be assigned within audits to manage ongoing activities, track due dates and report on assignments and progress.

Document management: Integrated storage within a centralized HIPAA-compliant repository allows support documents to be attached to audits and shared internally or externally.

“Our vision was always to scale MDaudit Enterprise into a single, integrated and comprehensive billing compliance and revenue integrity platform. We partnered with industry experts and our incredible customer community to develop External Audit Workflow to enhance cross-departmental collaboration and productivity, allowing compliance teams to meet even the most demanding audit workloads and schedules. The platform’s analytics further empower customers to track and mitigate tangible financial and compliance risks associated with external audits,” said Ritesh Ramesh, chief operating officer, Hayes.

External Audit Workflow is integrated into the broader MDaudit Audit Workflow solution, which provides hospitals and health systems the ability to conduct internal audits for both hospital billing, professional billing, and coder auditing, allowing for both prospective and retrospective audits. The addition of External Audit Workflow makes this the only solution on the market that can handle all the auditing needs of a healthcare organization.

To learn more about the MDaudit Enterprise External Audit Workflow solution, visit https://www.hayesmanagement.com/external-audit-management.