A Solution to your RAPS and EDS Compliance Challenges

Business Problem:

With all of the regulatory and reporting changes around CMS’s upgrade from RAPS to EDS, MAO’s are challenged to find the resources, technical specifications and budget required to get through both levels of submission Certification.

• The enhancements and technical specifications have not been fully defined.
• This initiative doesn’t fit into the standard SDLC process.
• Failure to execute the EDS initiative well will impact your quality rating, rebates and bottom line.

Add to this, the “ice berg” known as ICD10 readiness, and it’s time to look for someone who has gone through thisprocess and knows how to get the job done.

RAPS and EDS will need to run in parallel for at least one year during the transitional period.  Hiring additional internal resources to support two systems on a temporary basis is not cost effective.  Playing catch-up on all of the evolving content and best practices CMS has issued takes too much time.  The long-term benefits of this technology upgrade are a few years out, and this requirement is just more regulatory overhead with no short-term ROI to your business. 

CrossUSA Solution:

CrossUSA has successfully helped other MAO’s stay on top of this critical CMS initiative through in depth participation with CMS since the start of the RAPS to EDS project.  We understand the challenges associated with moving from the 5 fields previously collected by RAPS to submission of all the fields of a 5010 837 data set. 

• CrossUSA can dramatically shorten your development cycle to CMS submission Certification.
• CrossUSA understands how to get this data out of your claims application, formatted correctly, and ready to submit to CMS.
• CrossUSA can give you the technical resources and bandwidth to support submissions to both RAPS and EDS during the transition period.

Why CrossUSA?

• We have already helped other MAO’s achieve their Phase one EDS Submittal certification and know what it takes.
• CrossUSA has over 10 years of health insurance IT outsourcing experience from Rural America.
• Our cost model to operate from Rural America is significantly lower than most major metropolitan areas.