HRAA's ICDVisualizerTM Now Allows Hospitals to Reduce Denials From Third Party Payors Under ICD-10

Latest Functionality Reduces Interruptions in Cash Flow


Plantation, FL, July 17, 2013 (GLOBE NEWSWIRE) -- Health Revenue Assurance Holdings Inc. (OTCBB: HRAA) today announced that its ICDVisualizer software now enables hospitals to quantify potential denials using custom maps, and improve operations prior to the ICD-10 effective date.

Third party payors are converting their benefit plans to ICD-10 codes in anticipation of the deadline. However, industry analysts are expecting that fewer than half of the 144,000 ICD-10 codes will be accepted by commercial payors. An upswing in rejected claims is expected during the early months following the October 1, 2014 deadline; when unrecognized codes will start to be rejected. ICDVisualizer™ identifies the gaps which result in case management oversight, documentation review and increased hold times as allowed by state regulations. Additionally, ICDVisualizer™ analytics identify risks associated with coding patterns to mitigate interruptions to cash flow.  

ICDVisualizer™ identifies mismatches between hospital practice patterns and each payor's reimbursement code schedule. Analytics highlight the gaps between services provided and expected reimbursable codes in advance of rise in expected denials. DRG shifts are specifically identified, and revenue impacts are estimated for improved payor relations and transparency so that hospital executives can predict how code-based contract provisions will change.  

Building on the core General Equivalent Maps (GEMs) and Reimbursement Maps from the Centers for Medicare & Medicaid Services and standard MS-DRG groupings, ICDVisualizer™ shows potential gains and losses, by financial class, specific insurance plans and more:

  • Identifies shifts by third party payor
  • Provides insight into claim scenarios driving the shifts
  • Prioritizes impacts to better prepare for negotiations with each payor

"CFOs face a huge increase in denied claims, and millions of dollars in delayed cash flow, unless they correct the course using a tested and shared strategy between the hospitals and their third party payors" said Andrea Clark, chairman and CEO of HRAA. "With ICDVisualizer, hospitals gain predictive analytics to protect their revenue stream.  It's not October 1, 2014 that should keep CFOs up all night it's the six months following that date."

Clark continued: "Third party payors represent a critical source of revenue for providers and with this new feature  ICDVisualizer™ provides claim-specific drilldown capability to develop strategies for each payor". "Now is the time to begin strategizing with payors to prevent potential denials".

ICDVisualizer™ enables healthcare leaders to understand the exponential impact of the transition to ICD-10 and how it relates to reimbursement risks, clinical documentation quality, coding productivity and process changes. It is part of HRAA's Visualizer analytics platform, which provides healthcare decision makers with an integrated view of financial, operational, and clinical data across multiple sources of data.

About HRAA

HRAA (OTCBB: HRAA) interprets data to ensure that healthcare is efficient and effective for hospitals, providers and other healthcare organizations by pulling medical data together to create a predictive window to understand cost and revenues looking back and going forward. Founded in 2001, HRAA combines years of industry expertise with best-in-breed technology to create market leading business intelligence products and consulting services to ensure healthcare organizations are reimbursed for every pill they prescribe, every procedure they perform and every test they administer. HRAA both trains and supplies high tech workforce to generate the predictive data used by the whole healthcare system and offers a full suite of solutions needed to keep up with the ever-changing industry including data analytics software, business intelligence technology, medical coding, auditing, education, revenue cycle consulting, and ICD-10 transition solutions. For more information please visit:  http://www.hraa.com

Caution Regarding Forward Looking Statements

Certain statements in this news release and such conference call are forward-looking, including (without limitation) expectations or guidance respecting customer contract expansion, growing revenues and profits through organic growth and acquisitions, attracting new business that will increase HRAA's revenues, continuing to maintain costs and consummating any transactions. Undue reliance should not be placed on such forward-looking statements because the matters they describe are subject to known and unknown risks, uncertainties and other unpredictable factors, many of which are beyond the Company's control. The Company's actual results, performance and trends could differ materially from those indicated or implied by such statements as a result of various factors, including (without limitation) the continued strengthening of HRAA's selling and marketing functions, continued customer satisfaction and contract renewal, new product development, continued availability of capable dedicated personnel, continued cost management, the success and availability of acquisitions, availability of financing and other factors, as well as by factors applicable to most companies such as general economic, competitive and other business and civil conditions. Information regarding certain of those and other risk factors and cautionary statements that could affect future results, performance or trends are discussed in HRAA's most recent annual report on Form 10-K, quarterly reports on Form 10-Q, and other filings made with the Securities and Exchange Commission from time to time. All of the Company's forward-looking statements are expressly qualified by all such risk factors and other cautionary statements.

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