Universe Scrubber

Audit Universes Built on Order, Not Chaos

universe-scrubber

Audit universes—comprised of elemental business areas compiled and maintained for the audit planning process—are important for accurate monitoring, analysis and oversight of health-plan compliance programs. In fact, they have become a fundamental component of the Centers for Medicare & Medicaid Services (CMS).

However, the effort required to generate an accurate and compliant CMS universe is so high that many health plans do not routinely utilize them as an ongoing compliance tool.

Common audit universe issues include:

  • Assigned data in the wrong fields
  • Missing or inappropriate data
  • Repeated errors, despite CMS findings
  • File naming-convention errors
  • Incorrect template

Most of these are errors due to negligence or ignorance, and can result in higher costs, lower star ratings and wasted time.

Why face the risk of enforcement action? Clean CMS-compliant universes can be created accurately in under 2 minutes!

Proactive compliance establishes order. Reactive compliance ends in chaos.

Inovaare’s integrated Universe Scrubber quickly scrubs authorizations, claims, appeals and grievances on demand—at the click of a button—to generate an accurate, clean audit universe that’s ready for CMS submission. This automated cloud solution:

  • Reduces undercharges and denials
  • Speeds up appeals and grievances resolution
  • Optimizes operational cost to improve the bottom line

Features

  • Plug-and-play cloud solution for error validation
  • Business rules configured per CMS mandates
  • Three-layered validation process
  • All ODAC & CDAG universes listed
  • Secure FTP server for easy access to files
  • AI-based analytics
  • Error rectification suggestions

Key Benefits

  • Increased cash flow (scrubbed claims = paid claims)
  • Reduced administrative cost
  • Improved operational efficiency
  • Higher star ratings
  • Quicker identification of errors
  • Out-of-box dashboards and analytics

 

Isn’t it time to get proactive?

Contact us at info@inovaare.com or call at 1.408.850.2235