Wound care providers are facing increasing scrutiny from payers and regulators. The debate over Medicare’s Local Coverage Determinations (LCDs) for skin substitutes has sparked significant concern, and regardless of where policies land, one thing is clear—audits, fraud investigations, and denials for insufficient documentation are on the rise.
Recent high-profile cases, including a $900M fraud investigation in Arizona, highlight the growing focus on wound care billing practices, skin substitute usage, and medical necessity claims. Federal investigators are now actively examining manufacturers, marketers, and healthcare providers involved in the application of these products.
With rising compliance demands and increased payer scrutiny, physicians must ensure airtight documentation to justify Cellular and Tissue-based Product (CTP) use. The ability to demonstrate clear, measurable wound progression is now critical to securing reimbursement and avoiding penalties.
How eKare’s inSight™ Platform Helps Providers Stay Audit-Ready
In today’s regulatory landscape, data and documentation are the new currency. eKare’s inSight™ platform empowers providers with:
- Accurate, objective wound measurement (area, depth, volume)
- Automated tracking of wound progression over time
- Comprehensive, time-sequenced documentation to meet LCD checkpoints
- Pre-treatment, post-4-week, and pre/post-graft assessments
- Seamless EHR integration, reducing administrative burden and human error
With audits increasing, having clear, structured, and defensible documentation is no longer optional—it’s a necessity. eKare ensures every detail is captured, formatted correctly, and readily available to support audits and reimbursement claims.
Reducing Risk and Ensuring Compliance with Standardized Data
Beyond simplifying documentation, eKare’s advanced analytics and early-warning system help clinicians identify non-healing wounds early, ensuring compliance with LCD requirements for treatment adjustments.
By standardizing wound measurement and tracking across visits, eKare helps providers meet payer expectations for “high-certainty” evidence of treatment effectiveness, reducing the risk of denials.
A Leader in Wound Care Research and Clinical Trials
eKare has a strong track record of supporting clinical research and randomized controlled trials in wound care. Its technology has been trusted by research institutions and industry partners for rigorous, real-world data collection that meets scientific and regulatory standards.
This experience reinforces eKare’s role as a reliable partner for clinicians and healthcare organizations seeking to align with payer expectations for evidence-based treatment justification and CTP reimbursement.
Navigating the Future of Wound Care Compliance
With audits rising and reimbursement becoming increasingly data-driven, providers must take proactive steps to ensure compliance. eKare’s inSight™ platform is more than a documentation tool—it’s a strategic partner in securing reimbursement, reducing risk, and optimizing patient outcomes.
The question isn’t whether compliance burdens will grow—it’s whether you’re prepared.
By leveraging eKare’s technology, analytics, and research-backed validation, providers can navigate these challenges with confidence, ensuring that every wound care claim stands up to scrutiny.
