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ValentaBPO > Outsourcing > Medical & Dental RCM > MD Audit Shield – RAC

MD Audit Shield - RAC

MD Audit Shield - Prepare For RAC Auditing

The federal government has recently implemented the “Recovery Audit Contract (RAC),” a new control process intended to weed out the large volume of fraudulent medical claims. To accomplish this, the government hired private auditing companies to perform audits on medical records and claims billing in all 50 states. Audits may cover any provider who bills fee-for-service Medicare, Medicaid, or commercial insurance programs. The audits will check for evidence of fraud by examining three common indicators of fraud: 1) coding inconsistencies; 2) documentation to support the medical necessity of the services provided; and 3) overpayments or underpayments to providers.

This is a critical new procedure for all medical practices. If your practice’s claims & records are audited and any of the three inconsistencies are found, you will be required to pay back not only the overpayment but also interest. In addition, appeals have not been successful. And the auditing companies will continue to audit your practice every 45 days until they find no further evidence of fraud.

Reports estimate that the RAC program has already identified more than $1 billion in overpayments in just a few of the 50 states.

Valenta's MD Audit Shield - RAC Services

Why take a risk in your practice? Begin using our MD Audit Shield services to eliminate the chances of an audit proving inconsistencies in your billing. While nothing will keep the government from auditing your practice, our MD Audit Shield service will at least protect your practice in several ways. MD Audit Shield takes the following steps to ensure your compliance:

  • It reviews 50 records at random from your billing to check if any improper coding and non-compliance issues with Medicare/Medicaid appear.
  • It specifies what corrective actions are needed to comply with codes.
  • It performs any necessary changes to put you in compliance.
  • It stands behind you with assistance in the event you are audited.

Proof of Concepts

Reduce billing from 2 mins to 7 seconds.
ProcessManual time entry (Average)Automation time entry (Average)
Entering single patient details55 Seconds4 Seconds
Entering single provider details30 Seconds2 Seconds
Entering single insurance details25 Seconds1 Second
Expense Reduction Automation, Valenta BPO

Invoice Extraction Proof of Concept

Medical Billing Automation, Valenta BPO

Medical Billing Data Entry Proof of Concept

What sets us apart?

  • Reduce the time in communicating and collecting funds from patients with a seamless process via email in lieu of standard mail.
  • We will setup auto charge, allowing your patience to authorize payments quickly.
  • Automate the collection of payments with viabill.com (or a comparable platform). This will assist collection of payments from patients via auto charge and also manage your businesses payables and receivable. Yes, we can do your practice bookkeeping too!
  • We will setup PayPal for your business to accept payments from patients if they don't authorize auto charge, saving time. We will be notified instantly when payments are received, so you don't need to forward us any information.
  • We will process denied claims 3 times and send the full history to patients rather than just a statement. This will give your patients transparency and peace of mind that their claim is outstanding for services rendered for portions not covered by their insurer.
  • We have multiple billers working on different parts of the process. Our team is diversified to better enable us to avoid inefficiencies. We will have dedicated team members to lodge claims, while having dedicated team members reviewing denials, and have a dedicated team member to collect payments from patients, and so on. This way, the entire process is managed more effectively and efficiently.
  • We operate 24/7 which means we will be at least 3 times faster than your current biller or in-house process.

Why Valenta’s MD Audit Shield - RAC?

Unparalleled Experience

We offer more than 25 years of experience in providing medical administration solutions that save time, effort and money. Above all our RAC solution will ensure you are maintaining legislative compliance.

Security First

We are ISO 27001 certified and supported by cutting-edge technology and infrastructure to maintain patient privacy and confidentiality.

Software Expertize

Our team are highly experienced across all of the major software solutions for medical billing, ensuring we fit within your business, and we can start work immediately.

Affordable Solutions

Our RAC solution is affordable and efficient, ensuring you can focus on what matters, your patients.

Boost Revenue

through streamlined operations with a

FREE Operational Analysis

Valued at $5,000

Why Valenta’s MD Audit Shield - RAC?

An Extension of Your Team

Our specialist team are a true extension of your business, whereby we can customize solutions according to your current processes.

Security First

We are ISO 27001 certified and supported by cutting-edge technology and infrastructure to maintain patient privacy and confidentiality.

Software Expertise

Our team are highly experienced across all of the major software solutions for medical billing, ensuring we fit within your business, and we can start work immediately.

A Highly Skilled Team

Our team are proficient with ICD-10, CPT and HCPCS codes across different specialties, payer-specific medical coding requirements, as well as government, regulatory and insurance requirements.

Peace of Mind with Valenta BPO

24x7 Support

We have a global presence with offices in Australia, UK, and US, backed by well-staffed delivery centres in Bangalore, Vizag, Ahmadabad and Mohali in India, and Penang in Malaysia enabling us to support you 24×7.

Local Managing Partners

We have a team of Local Managing Partners in the US who will provide the support and guidance you need to improve your business efficiencies and drive growth. Having a strong local presence allows us to provide the best business solutions for you as we understand the local business landscape.

Eliminate Hiring & Administration Costs

At Valenta BPO we offer outsourcing solutions that eliminate the need for you to invest in IT, HR, payroll, account management and admin tasks. On average, our Valenta BPO client's who outsource report a cost saving of up to 60%.

Flexible Engagements

We design solutions to meet specific client requirements and offer flexible engagement models. Our resources can be engaged full time, part time, or on a transactional basis without lock-in contracts.

What do our client's say?

  • It’s really helped me gain scale and leverage on my most important business processes. If you find yourself running out of time, and you want to work with the best team you should consider Valenta BPO.

    Timothy J McNeely
    Lifestone Companies
  • Since engaging Valenta, we’ve been able to take on a much higher work load. We’ve been able to bring someone into the team for a lower cost, but without compromising on that quality of work. Outsourcing has been a great solution compared to hiring somebody locally. It’s a lot more cost effective and it’s easy to do.

    Natalie Gillies and Clare Harding
    Arthur J Gallagher
  • We have found Valenta’s service to be very professional, very capable and very timely. As a result, it’s increased our productivity and reduced our bottom line. We’ve had some very good cost savings with our outsourcing arrangement with Valenta. We found their cost is very competitive compared to the market which has benefited our bottom line.

    Tommy Laskaris
    Oracle

Valenta’s MD Audit Shield - RAC Solutions

General Practice and Dental

Tiered and fixed pricing based on practice analysis

Enterprise Level including Hospitals

Custom Solutions

Software Expertise

Book Free MD Audit Shield – RAC Consultation

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