eSolutions October Newsletter

eSolutions October Newsletter


Product Updates


Maven Follow-Ups

The follow-up feature on the Home tab in Maven has been enhanced to allow advanced filtering. When you mark an appeal or ADR for follow-up, the claim displays in the Claims marked for follow-up section of the Home tab. You can now use the My Groups drop-down to view all follow-ups, or filter by group (based on your permissions).

eSolutions September Newsletter

Worried about Pre-Claim Review? We've got you covered.

If you’re a home health provider in Illinois, Florida, Texas, Michigan or Massachusetts, it’s likely that the CMS pre-claim review demonstration has been one of your chief concerns. In case you’ve missed out on our recent pre-claim review webinar series, we want to assure you that we’re committed to making these changes as painless as possible for you.

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.

CAHABA Medicare Expo 2015

Cahaba GBA held its third annual Medicare Expo on August 19th and 20th in Birmingham, AL.  This was an outstanding networking and educational event for both Part A and Part B Medicare providers. Held over two days, (day one for Part A and day two for Part B) hot topics such as ICD-10, Provider Customer Service Program (PCSP) and Electronic Submission of Medical Documentation (esMD) were covered in daily educational forums.

Blog Newsletter | June 2015

The true cost of an audit response tool

When it comes to picking an audit response tool, you have a lot of options. With so much at stake, it can be difficult to make sure you’re picking the right one. Sure, you can save some money up front with a budget tracking system, but if you aren’t accounting for the investment of your time, you haven’t fully calculated the cost.

Redetermination Requests Now Accepted Through esMD

MACs JK (NGS) and J6 (NGS) are now accepting Level 1 appeal (Redetermination) requests through esMD.  A Redetermination request is a request for re-examination of the initial claim decision. It is conducted by the MAC or DME MAC.

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.