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Atlanta, GA. – September 28, 2009 – Compliance 360, a leading provider of Software-as-a-Service (SaaS) solutions for enterprise governance, risk management and compliance (eGRC) today announced that the Compliance 360 Claims Auditor has achieved PLATINUM level status, the highest level of integration certification status from Executive Health Resources (EHR), the leading provider of medical necessity compliance and denials management solutions. The certification, called “EHR Integrated™,” validates that by using the Compliance 360 Claims Auditor, hospitals will be able to seamlessly send and receive denial appeals data and status updates, including data and updates relevant to all governmental auditing programs such as Recovery Audit Contractors (RACs) , Medicare Administrative Contractors (MACs), Zone Program Integrity Contractors (ZPICs), and Medicaid Integrity Contractors (MICs) to and from EHR.

The Compliance 360 Claims Auditor, selected by more than 200 hospitals across the country, helps healthcare providers take control of the claims audit and appeal process to minimize the loss of revenues.  This unique solution automates the management of the entire claims audit process across all departments and creates organizational accountability.  With automated workflow and the ability to customize workflow templates for different types of claims audits, the Claims Auditor functions as the “Virtual Audit Coordinator”, enforcing deadlines and due dates throughout the organization and providing alerts that help prevent automatic recoupment.  The compliance 360 Claims Auditor also serves as the claims audit system of record, consolidating the management and tracking of RAC audits and other types of claims audits including MIC, MAC, ZPIC, PSC, CERT, MFCU, commercial payor audits and others, into one system for centralized control and assessment of overall financial exposure.

As part of the certification process, the Compliance 360 Claims Auditor will be tested to ensure that it integrates with EHR’s internal, proprietary enterprise technology systems through accurate data and image sharing across an inbound/outbound data exchange interface that was created by EHR. Upon completion of the testing, it was determined that the Claims Auditor is compatible with the EHR’s data exchange, resulting in its EHR Integrated™ certification.

“Our recent EHR Integrated™ designation underscores our continued commitment to help hospitals in achieving greater process efficiencies, accuracy and effectiveness during a time of increased scrutiny by auditing bodies,” states Thomas Stitt, Vice President of Business Development for Compliance 360.  “Given the labor-intensive and long-term nature of managing and appealing payor denials, we are pleased to work with EHR to help hospitals streamline this process so that their focus can be on the hospital’s primary mission of delivering quality healthcare.”

EHR processed more than 28% of all medical necessity RAC appeals during the demonstration project, making it the largest single RAC medical necessity appealing organization. The EHR Integrated™ certification program was established to provide an easy way for EHR’s 800+ hospital clients to identify the software solutions that can exchange data and images with EHR. This integration can provide EHR’s hospital clients a way to reduce their appeals data processing time, to maintain data integrity and to allow them timely access to appeals process status.

“By utilizing an EHR Integrated™ solution such as the Compliance 360 Claims Auditor, hospitals that partner with EHR to manage their medical necessity denials and appeals will experience meaningful time and cost savings in avoiding the manual transfer of data to and from EHR,” explains Mike Modiz, Director of Operational Effectiveness for EHR. “In addition, EHR will receive appeals data and provide status updates more quickly. This allows for immediate action by our appeals management team and more timely access to the status and result of each appeal by hospital clients.”

About Compliance 360 for Healthcare

Compliance 360 is the leading provider of enterprise governance, risk management, compliance and audit management solutions for healthcare providers.  With these solutions, healthcare providers reduce risks, improve efficiencies and protect their brands using a single platform to address their comprehensive GRC requirements.  The Compliance 360 solution for healthcare addresses the need for policy management, centralized regulatory management including HIPAA, EMTALA, STARK and others, Joint Commission Accreditation, OIG corporate integrity agreements (CIA), False Claims Act (FCA) Compliance, adverse-event management, contract management, surveys, remediation projects, claims audits and denials, Medicare RAC audits, Medicaid MIC Audits, self assessments, and enterprise risk management.  Industry leading healthcare providers that depend on Compliance 360 include Billings Clinic, Catholic Healthcare Systems, IASIS Healthcare, InterDent, Jackson Memorial Hospital, LifeLink Foundation, LHC Group, Methodist Hospital, MultiCare Health System, Nassau University Medical Center, PeaceHealth, Rush Health Systems, Saint Joseph's Hospital of Atlanta, St. Elizabeth Medical Center, St. Luke's Health System and Spectrum Health.  To learn more about the Compliance 360 solution for healthcare, visit www.compliance360.com/healthcare.

About Executive Health Resources