What's the Latest on Pre-Claim Reviews?

The Pre-Claim Review Demonstration (PCRD) that began in Illinois back in August is off to a less than ideal start. Because of this, the demonstration has been delayed in Florida, Texas, Michigan and Massachusetts until further notice. What does this mean for you, and how can you best prepare for PCRD?

eSolutions July Newsletter

Load Multiple RTP Claim Forms in MedicareACE

We want to make sure that you’re able to work RTP claims in the most efficient manner possible. To accomplish this, MedicareACE now allows you to load multiple UB-04 claim editing forms to let you get more done in less time. You can now easily page through your RTPs and make corrections in the familiar UB-04 format.

eSolutions Newsletter: April 2016

Check Out Our New Multi-Payer Solutions

As you may know, eSolutions recently acquired ClaimRemedi. Based out of Santa Rosa, California, ClaimRemedi is a provider of billing systems and clearinghouse services. You already know about the many ways eSolutions can help with your Medicare billing, so here’s a rundown of everything we now have to help you with your other payers.

Keep Track of Your Most Important ICD-10 KPIs

As a provider, you know that productivity and cash flow are essential to keeping your business up and running. Now that CMS has made ICD-10 the standard it’s more important than ever to keep track of your claims and make sure you get paid. With about five times more codes than ICD-9, the ICD-10 migration could potentially mean more denials and hang-ups.

Update on CMS Recovery Audit Program and RAC Audits

Sign up for our free webinar to learn the latest on the Recovery Audit Program and RAC Audits.

eSolutions is pleased to present Brian Elza, Director of the Division of Recovery Audit Operations (Provider Compliance Group/Office of Financial Management) at the Centers for Medicare & Medicaid Services (CMS).  Mr. Elza will discuss the recent developments in the Recovery Audit Program. Join us on Wednesday, March 25 at 1 PM CST for this informative and interactive presentation.

eSolutions Newsletter | November 2014

RAC Audits are Back!

After an extended break, it appears the Recovery Audit Contractor (RAC) audits will soon start to pick up steam. At this time, CMS is initiating contract modifications to the current recovery auditor contracts to allow the recovery auditors to restart some reviews. Most reviews will be done on an automated basis, but a limited number will be complex reviews of topics selected by CMS.  Complex reviews may include DRG validations (coding reviews), surgery, and therapy.

eSolutions Newsletter | June 26, 2014

Are you ready for the CWF to HETS transition?

CMS will terminate access to CWF eligibility queries through HIQA, HIQH, ELGA, ELGH and HUQA later this year. When this transition occurs, Part A providers will undergo a huge change in how they verify Medicare eligibility. It’s essential that you’re ready!

The change over to the HIPAA Eligibility Transaction System (HETS) will require your intake staff to modify workflow procedures and learn a new computer interface. By transitioning early, you’ll be able to make the change with minimal interruption to your daily procedures. This change can become even easier if you use MVP Live to check Medicare eligibility.