QuadraMed’s HIM RAC Assistance Solutions and Services:

 

QuadraMed’s HIM solutions and consultative services  take the stress out of RAC audits. From identifying existing areas of risk to preventing future occurrences and responding to demand letters, our products and services help healthcare organizations every step of the way. We provide the information needed to proactively eradicate coding inaccuracies and manage RAC processes. Clients gain confidence in their organization’s ability to withstand an audit because they know QuadraMed’s RAC product and services will provide support throughout the entire process.

QuadraMed’s HIM Consultative Services include:

  • RAC Readiness Service:

QuadraMed helps assess healthcare organization’s potential and vulnerability for RAC audits. By performing comprehensive audits of selected populations of inpatient and outpatient charts, QuadraMed’s auditors will identify RAC vulnerability and coding and documentation inaccuracies. QuadraMed’s RAC Readiness services also include a review of medical necessity documenting practices, validation of MS-DRGs for selected patient populations, and appropriate selection of principal diagnosis, etc. QuadraMed’s team of auditors help clients educate staff members by documenting all RAC-related findings, results, and recommendations through comprehensive written reports or onsite assistance

  • RAC Response Service: 

QuadraMed’s RAC Response Service supports healthcare organizations throughout the RAC audit process. All RAC demand letters are forwarded to QuadraMed’s Response Team for review. QuadraMed’s team of coding professionals assesses each requested record for coding accuracy, completeness of documentation and satisfaction of medical necessity criteria. Reviewed records are tracked to establish trend results. If an opportunity for a RAC appeal arises, QuadraMed provides supporting documentation.

  • Clinical Documentation Improvement (CDI) Service:

QuadraMed’s Clinical Documentation Improvement Service help healthcare organizations reduce the risks associated with incomplete clinical records. Through our CDI services and educational programs, clients improve their clinical documentation and coding processes while ensuring accurate reimbursements. Deficiencies are caught through our retrospective review and analysis of existing documentation. Our services are customized to fit the requirements of each organization’s EHR and tailored to meet the unique specialties of each facility’s clinicians.

 

QuadraMed’s HIM RAC Assistance Solutions:

Reduce risk exposure with an enterprise-wide compliance management solution. Manage and monitor RAC compliance in real-time, during the coding process to avoid downstream audits, penalties and other compliance issues. QuadraMed Inpatient & Outpatient Compliance includes customizable RAC edits and reporting tailored to meet each facility’s unique business needs. This solution integrates easily with QuadraMed Facility Coding and other Hospital Information Systems.

 

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Questions?



            For questions about QuadraMed’s HIM RAC solutions and services, contact
            Gina Sanvik, RHIA.