New audit software helps to identify potential problems

Friday, December 29, 2017

FORT LAUDERDALE, Fla. – It’s no secret that audits, and all the administrative complexities that accompany them, have been the bane of the HME industry for years. But a recently formed partnership between HME stakeholders aims to change that.

Dubbed RxCloud9, LLC, the partnership between HME business owners and a HME billing software developer is poised to release a software package that aims to simplify—and, more importantly, clarify—the audit process.

“The value in this product is understanding the consequences of failing an audit and/or not appealing an audit,” said Justin Ferreira, a principal in the partnership.

Some of those potential consequences include loss in payment, prepayment reviews and provider number revocations, any of which, Ferreira said, “can be a complete death sentence for a provider.”

As Ferreira explained it, RxCloud9 simplifies the audit process by organizing where you are and what is needed to get your audit packaged for a successful submission. Whether it’s an initial response to an audit or an ALJ appeal, it manages the process the same way.

“Besides audit and task management,” he added, “the system will calculate your error rate by contractor. This is important information to know because this is what will trigger one of those fatal consequences. The system will help you understand your exposure, or in other words, allow you to identify a potential problem that can be fixed before you have a real problem.”

While the RxCloud9 product aims to fill a void in the HME industry, Ferreira noted that the software can also be used by pharmacies, home health agencies, and even physician practices—“any company who will receive an audit from a payer,” he said.

Out of the gamte, Ferreira said the software package will be offered via a free “no obligation two-month trial.”