AuditNavigator™ - Feature Specification List
 
AuditNavigator™

Function Feature Wellington
AuditNavigator™
Tracking and Management User configurable (payers, audit type, events, issues, time frames, custom fields) Included Feature
User-specified workflow (tasks, responsible person, alerts) Included Feature
Appeal Type Sensitive Workflows (medical necessity, coding, etc.) Included Feature
Historical claim database for easy data entry (up to 3 years of claims history) Included Feature
Electronically scan request letter information into the system Included Feature
Retrieve data from claim history database to minimize data entry Included Feature
Task work list by user Included Feature
Peer-to-Peer Appeals Scheduling Included Feature
Automatically checks if claim was previously requested or excluded from audit Included Feature
Document repository (upload and attach document in pdf, doc, xls format to request or claim) Included Feature
esMD –Electronic Medical Record Submission to participating CMS contractors (MAC, RAC, etc.) Included Feature
Attach comments to request or claim Included Feature
Auto recoupment deadline alerts Included Feature
Cost tracking - Track pages copied, postage and any other costs by claim Included Feature
Appeal letter templates populated with data from claim Included Feature
Task status dashboard with drilldown to individual claims Included Feature
Generate CD/DVD containing requested medical records Included Feature
Supports most all audit/appeals processes (RAC, Medicaid, CMS, ZPIC, MIC, PrePay, etc.) Included Feature
Log all RAC financial offsets using 835 remittance files, attach to claim and notify user Included Feature
Generate AHA RACTrac compatible summary file Included Feature
Pre-Bill Audit tracking and support Included Feature
Case Management tracking and documentation support Included Feature
Tracking of Inpatient claims rebilled as outpatient claims Included Feature
EHR Integrated Electronic Document and Information Exchange – Platinum Level Approved for all EHR appeals Included Feature
Auto-populates EHR required documents Included Feature
Automatically updates document status from EHR system (appeal levels, denials, etc.) Included Feature
Reporting Activity Dashboards Included Feature
Financial In-Process Reporting Included Feature
RAC Take-back (via remittance (835) processing) Included Feature
Summary by DRG Included Feature
Data Integrity Analysis Included Feature
Denial Recovery Rate Included Feature
EHR Status Report Included Feature
Request Status Summary Included Feature
Claim Issue Listing Included Feature
Appeal Status Included Feature
Management summary Included Feature
Ad hoc Reporting Included Feature
Automated Interfaces Medical Record Retrieval Included Feature
RAC Site Monitoring and Data Collection Included Feature
FISS System Monitoring and Data Collection Included Feature
System Web-based (.Net/SQL Server/LDAP) Included Feature
Multiple payers Included Feature
Multiple hospitals/entities Included Feature
Secure FTP claim upload process (daily database updates) Included Feature
Secure remote access by authorized external users (e.g., coders, attorneys) Included Feature
HIPAA/HITECH Compliant Included Feature
Security Monitor Reporting Included Feature

AuditNavigator™


 

Contact Information Contact The Wellington Group for more information