| Module |
Feature |
Wellington
RAC Guard™ |
Other
Vendor |
| System |
Web-based (.Net/SQL Server/LDAP) |
 |
|
| Multiple hospitals/entities |
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| Secure FTP claim upload process (daily database updates) |
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| Secure remote access by authorized external users (e.g., coders, attorneys) |
|
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| Management |
User can turn individual issues on or off |
|
|
| Prevention |
Edit current and historical claims for RAC issues |
|
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| Ongoing updates to include newly released RAC Issues |
|
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| Assess risk of selection/denial for each claim (separate methods for coding and medical necessity issues) |
|
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| Determine number of claims with issue and financial exposure |
|
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| Monitoring |
Vulnerability trends with drilldowns by DRG, physician, etc. |
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| RAC target issue trends with drilldowns by DRG, physician, etc. |
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| Financial impact analysis and trends |
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