Audits are challenging and impactful! They are time-consuming undertakings for healthcare organizations and can dramatically affect provider reimbursements, future and existing contracting opportunities, and often drive internal financial decisions. As many payor reimbursement models are progressively transitioning from “fee-for-service” to “value-based” reimbursement, audit requests can directly impact opportunities to either receive financial incentives or experience financial penalties.
Organizations are forced to reduce office hours or close offices entirely, leaving them in a more difficult situation than ever before. Limited onsite access, reduced labor hours, and having to furlough well-trained employees are now the new barriers organizations must overcome during this important time of the year.
To mitigate the impact of COVID-19 during Medicare/Medicaid risk adjustment audit season, consider the following:
- With the stress created by the ever-growing multitude of health plan audits, organizations can partner with leading release of information providers to reduce cost and delays by offloading the labor allocations necessary to comply with audit requirements; eliminating privacy risks from unknown entities accessing your offices, charts and EMRs; and reducing errors tied to the 11th hour multi-chart demands.
- Unparalleled deep domain expertise can be hard to find in an employee and if they leave, that expertise is gone. By having a release of information partner, like Sharecare Health Data Services, whose employees are Certified Release of Information Specialists (CRIS), organizations can be confident that their patients’ PHI is protected, and the audit fulfillment process is secure, HIPAA- compliant, and automated.
- Finally, because audit season carries deadlines, overwhelmingly short sometimes, fulfillment of an audit request can severely affect the labor allocation required to finish the job. Especially during a pandemic, the gift from having a partner like Sharecare Health Data Services to assist, gives flexibility to reallocate resources into more meaningful tasks. Additionally, the staff can rest assured all audits are completed in a timely and accurate manner. Having a deep understanding of a multitude of health plan audit requirements, including but not limited to HEDIS, Risk, RADV, etc., is critical when reimbursements are tied to the bottom line.
Both Healthcare Payors and Providers are now benefiting from working with Release of Information experts. “Having Sharecare Health Data Services available to process the hundreds of patient chart audit reviews we receive year-round takes a tremendous burden off our medical records staff. This task is a very time-consuming project and since there are timelines to produce these records, I know they will be processed by Sharecare Health Data Services in a timely manner,” says Donna— Medical Record Team Leader, a Sharecare Health Data Services’ client.
With nearly 30 years of proven HIPAA-compliant release of information, Sharecare Health Data Services is a preferred Business Associate to some of the largest health organizations in the world and subsequently; has undergone rigorous, exhaustive testing by their security departments. Many of the clients have expressed relief in being able to shift the labor and liability to Sharecare and excitement at being able to participate in the financial incentives offered by many Payors.
Sharecare Health Data Services makes risk adjustment season easy!
