OmniSys puts tech spin on audit response

Wednesday, September 11, 2013

DALLAS – OmniSys hopes to do for audits what TurboTax has done for taxes.

The company, which processes more than 40 million claims for more than 35,000 providers annually, recently launched OmniGuard, a web-based tool that automates the audit process—everything from collecting documentation, to packaging and submitting responses, to providing status updates.

“You log in and it asks you, ‘Hello, do you have an audit in front of you?’” said Matt McGrath, director of business development for OmniSys. “You enter the information, hit enter and then you forget about it.”

Unlike TurboTax, however, OmniGuard combines technology with people. Once a provider has entered audit, physician and patient information, and uploaded supporting documentation, specialists take over, working the audit through to the administrative law judge (ALJ) level. They’ll even reach out to physicians and beneficiaries to collect medical necessity documentation.

OmniGuard especially appeals to smaller providers that don’t have the resources or wherewithal to handle an increasing number of audits, McGrath says.

“If you’re a smaller shop, you can hire more people to handle the increase in audits, or you can let us do the bulk of the work,” he said. “We know the government has no plans to slow down audit activity, so this has become an interesting solution for providers.”

OmniSys charges providers a set amount for a minimum of five audits and an additional fee for each audit over and above that. It has been well worth the investment for Joey Esparza, a one-man billing department for Guardian Home Care Services in Lubbock, Texas.

“We had 13 audits a couple of months ago and we had a couple last month, so it’s been helpful,” he said. “It’s also nice to have a second opinion on what Medicare’s looking for.”