Commercial claims auditing software
Commercial claims auditing software
This criticism comes on the heels of another GAO report critical of HCFA's initial decision — now revised — not to use already developed commercial auditing software to identify inappropriate physician coding claims. Reversing its stance, HCFA plans within a year to contract for and install commercial claims-auditing software designed to identify incorrect physician codes. HCFA anticipates that the change will save $465 million annually in Medicare overpayments.
HCFA initially rejected the idea of purchasing commercial software because officials thought the agency could develop similar software cheaper in-house. That was a "flawed idea" from the beginning, according to the GAO, considering that after six years of trying, HCFA was still not able to develop similar software.
Meanwhile, HCFA's concern about being forced to disclose claims-auditing edits and computer logic used by an agency vendor is also unfounded, the GAO argues.
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.