PORTSMOUTH, N.H. (July 28, 2016)—ChartaCloud Technologies LLC today announced its agreement with OPERACARE Inc. to introduce and offer its CMS OASIS claims, pre-submission claims and proactive OASIS analytics software and services. OPERACARE will be offered via ChartaCloud’s ChartaCares health care services business. OPERACARE’s design and development was led by an experienced CMS/State OASIS Coordinator skilled in claims data monitoring and OASIS Analytics as utilized by CMS/MAC auditors to oversee payment claims validity and fraud detection programs.

The software and supporting review service enables home health care providers to have their CMS claims reviewed by a third party, submit accurate health care episode documentation, manage re-certifications and provide accurate pre-claim submissions in an era of increasingly aggressive CMS/Auditing protocols. In addition, OPERACARE provides the basis for identifying opportunities for enhanced billing and providing outcomes data monitoring used to enhance HHA growth and financial stability in the new era of "value based purchasing/payments" for HHA services.

“Health care providers and their compliance officers are quite aware of the increasingly aggressive nature CMS’s MAC (Medicare Administrative Contractor) and RAP (Resource Allocation Plan) audits. Skilled homecare service providers are being increasingly subjected to audits driven by claim inaccuracies, whether being done purposefully, inadvertently or inaccurately. While avoiding an audit is the first priority, profitably surviving in an industry under intense consolidation is a strategic imperative. Bottom line to both challenges is that claims have to be accurate, prepared in a timely manner and correctly coded,” said Michael McGowan, CEO, OPERACARE. “With CMS’s increased MAC attention on expanding HHA audits and the pushing of MACs to be more aggressive, hundreds of preventable desk review risks are in play. Our policy which has been built into our system and service, is straight forward, don’t submit what you can’t defend. If we detect a concern we will call the provider,” he concluded.

“We are of course very excited about the expertise and the power found in OPERACARE to not only help our HHA customers submit accurately prepared claims but also with OPERACARE’s ability to help transform the business models of health care service providers to what is needed to survive, achieve financial stability and to grow new business. Having a system that enables resource allocation plan (RAP) submissions within 2-4 hours of a start/statement of care (SOC) visit and transitioning to a value based purchasing model to grow their businesses were very significant elements in our choice to offer OPERACARE,” said Rob Schimmel, COO, ChartaCloud. “In the end and as in any business, performance matters. And, we believe OPERACARE delivers significant performance benefits to HHAs,” he added.

More on OPERACARE can be found at: ChartaCloud OPERACARE