Navigation Links
Cain and Associates Launches Government Audit Protection (GAP) Service

Innovative Service Helps Hospitals and Health Systems Reduce the Likelihood of an Audit from a Medicare or Medicaid Recovery Audit Contractor

PHOENIX, Jan. 14 /PRNewswire/ -- Arizona-based Cain and Associates (C&A) ( today announced the launch of its new Government Audit Protection (GAP) service. GAP was specifically created as a pre-review process to assist hospitals and health systems minimize compliance and financial risks in light of new government Medicare and Medicaid recovery audit contractor programs. The initial and best known of which is the Recovery Audit Contractor (RAC) program. RAC began on October 6 in 19 states, and will be implemented in all 50 states by 2010. The RAC program concentrates on Medicare payments and allows third-party auditors to keep from 9.4% to 12.4% of payments identified as improper and then collect them from providers.

"Hospital executives must be proactive in this difficult regulatory climate and GAP is a perfect vehicle for self-auditing," notes C&A CEO Scott Cain. "In the initial audit test cases performed by RAC in California, Florida and New York in 2006 and 2007, almost $11 billion in faulty billings were uncovered. It's essential for providers to identify claims that were improperly paid, make voluntary refunds for payment and communicate the claims numbers to the carriers."

Centers for Medicare and Medicaid Services (CMS) is now mandated to vigorously collect overpayments and aggressively seek out provider fraud. According to CMS, most overpayments are due to "lack of medical necessity" and lack of documentation. The goals of the initiative are to identify past improper payments and recoup overpayments in the Medicare FFS program, as well as helping to prevent future improper payments thereby lowering the Medicare FFS error rate.

According to Cain, hospitals and physician practices are at risk for a potential audit. This includes hospitals, hospital administrators, subcontractors, physicians and consultants. GAP works to assess the company's exposure, and C&A will also work with groups in the appeals process if they have already been audited.

"GAP is one of the only services in the country with the ability to safeguard every group affected across the board and ensure compliance with RAC (Medicare) and MIC (Medicaid) audits," adds Cain. "As with all of our services, we are not a cost center, but rather, a benefit - we charge a minimal fee per account file reviewed or per bill appealed."

Cain and Associates takes technology and applies it to information to create revenue opportunities for hospitals. C&A's GRIP product insures that patients who are eligible for Medicaid coverage are identified. CORE uses proprietary data mining techniques and network access to capture commercial insurance eligibility information that generates additional funds for each hospital. In 2000, Cain and Associates began working with hospitals to execute their innovative services. So far, the firm has recovered over $20 million in lost revenue for their clients. C&A accomplishes this with proprietary software and consultation to perform the industry's deepest data querying and analysis.

Cain and Associates, LLC (C&A) creates revenue opportunities for hospitals through proprietary technology and information gathering techniques. They have saved hospitals millions of dollars serving clients in New York, Virginia, Maryland, South Carolina, Ohio and Kentucky. For more information, please visit or call (800) 817-2148.

Cain and Associates: The Business of Health Care

SOURCE Cain and Associates
Copyright©2009 PR Newswire.
All rights reserved

Related biology technology :

1. Dr. John Stephen Osika, HIV/AIDS and Infectious Disease Expert, Joins Abt Associates
2. Norton & Associates Inc. Adds $3bnUSD Commercial Real Estate Investment P & L Management Holding Group; US Property Portfolio Inc.
3. Kornberg Associates Architects Opens Tokyo Office
4. Crystal Research Associates, LLC Issues Executive Informational Overview(R) (EIO(R)) on The Medical House PLC
5. Newly Integrated Software Suite From ZS Associates Offers Comprehensive Set of Sales Performance Management Software Solutions
6. Core Laboratories Joint Venture Agreement Between genae associates, VIBGYOR Scientific Research, Cardiovascular Center Aalst and J.B. Dahm
7. BioMS Medical to present at Sachs Associates Biotech in Europe Forum
8. Crystal Research Associates, LLC Issues Executive Informational Overview(R) (EIO(R)) on Generex Biotechnology Corporation
9. Abt Associates Ranked One of Top 20 U.S. Market Research Firms
10. Second Quarter Health Care M&A Strongest In Years According To New Report From Irving Levin Associates, Inc.
11. ARUP Laboratories Partners With Pathology Service Associates
Post Your Comments:
(Date:11/24/2015)...  Clintrax Global, Inc., a worldwide provider of clinical research services ... that the company has set a new quarterly earnings record in ... growth posted for Q3 of 2014 to Q3 of 2015.   ... , with the establishment of an Asia-Pacific ... United Kingdom and Mexico , ...
(Date:11/24/2015)... ... 2015 , ... This fall, global software solutions leader SAP and AdVenture Capital ... and pitch their BIG ideas to improve health and wellness in their schools. , ... win the title of SAP's Teen Innovator, an all-expenses paid trip to Super Bowl ...
(Date:11/24/2015)... Massachusetts , November 24, 2015 SHPG ... will participate in the Piper Jaffray 27 th Annual Healthcare ... Tuesday, December 1, 2015, at 8:30 a.m. EST (1:30 p.m. GMT). ... , Chief Financial Officer, will participate in the Piper Jaffray 27 ... , NY on Tuesday, December 1, 2015, at 8:30 a.m. ...
(Date:11/24/2015)... -- Tikcro Technologies Ltd. (OTCQB: TIKRF) today announced that its Annual General Meeting ... Israel time, at the law offices of ... th Floor, Tel Aviv, Israel . ... Izhak Tamir to the Board of Directors; , election of ... approval of an amendment to certain terms of options granted to our ...
Breaking Biology Technology:
(Date:11/18/2015)... New York , November 18, 2015 ... Market Research has published a new market report titled ... Growth, Trends, and Forecast, 2015 - 2021. According to the ... in 2014 and is anticipated to reach US$29.1 bn ... to 2021. North America ...
(Date:11/16/2015)... Calif. , Nov 16, 2015  Synaptics ... of human interface solutions, today announced expansion of ... TouchView ™ touch controller and display driver ... revolution of smartphones. These new TDDI products add ... TD4100 (HD resolution), TD4302 (WQHD resolution), and TD4322 ...
(Date:11/10/2015)... LONDON , Nov. 10, 2015 /PRNewswire/ ... segmented on the basis of product, type, ... segments included in this report are consumables, ... this report are safety biomarkers, efficacy biomarkers, ... in this report are diagnostics development, drug ...
Breaking Biology News(10 mins):