Integrated Software Solutions from 3M Support Medical Necessity Compliance
New software enhancements from 3M Health Information Systems promote medical necessity compliance across the outpatient revenue cycle.
Salt Lake City, Utah (PRWEB) November 1, 2007
New software enhancements from 3M Health Information Systems promote medical necessity compliance across the outpatient revenue cycle. 3M™ Medical Necessity Online (http://solutions.3m. com/wps/portal/3M/en_US/3MHIS/HealthInformationSystems/solutions/medical-necessity/), used for pre-service medical necessity validation, now integrates with 3M™ Ambulatory Revenue Management Software to provide comprehensive access to all pre-service medical necessity data.
The combined software solution offers greater control over revenue cycle processes by making it possible to review and correct medical necessity during coding and billing. The result is fewer billing errors and reduced payment denials, rework, and write-offs.
3M Ambulatory Revenue Management Software unites medical necessity data from 3M Medical Necessity Online with coded data from the chargemaster, HIM department, UB92 and remittance advice, plus industry-standard and 3M-proprietary edits into a central data source for analysis and reporting. Using this powerful outpatient revenue management solution, hospital staff can review and verify critical edits and charges in one consolidated view. Problem areas can be identified, corrected, and monitored over the long-term.
3M Medical Necessity Online alerts staff in centralized and ancillary department registration and scheduling if proposed patient care does not meet Medicare medical necessity and commercial payer preauthorization requirements. The software helps resolve potential medical necessity failures, alerts staff when payer pre-certification is required, or creates and stores Advanced Beneficiary Notices (ABN) for Medicare patients. 3M Medical Necessity Online provides secure, password-protected, enterprise-wide access via the Internet to authorized users.
"Addressing medical necessity errors after a claim is denied is a time-consuming and expensive process," said Jerry Kolosky, vice president, Medical Necessity and Compliance Solutions for 3M Health Information Systems. "Providing access to medical necessity data at key checkpoints of the revenue cycle--from scheduling and point-of-service, to coding and billing--promotes efficient workflow and accurate, timely reimbursement."
Medicare, state Medicaid organizations, and commercial payers have established policies for determining whether provider services are medically necessary and eligible for reimbursement. The complex regulations that define Medicare medical necessity include National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs). Commercial payer pre-certification policies create an additional level of complexity. Non-compliance with medical necessity regulations and pre-certification policies carry heavy penalties and can cause claims errors which have a significant impact on a healthcare organization's financial status.
More information about the integrated 3M Medical Necessity Online and 3M Ambulatory Revenue Management Software solution is available at www.3Mhis. com or by calling 800-367-2447.
About 3M Health Information Systems
3M Health Information Systems is the worldwide expert in healthcare funding and performance management solutions. Built on nearly 25 years of experience delivering superior coding, grouping and abstracting products, 3M Health Information Systems provides solutions that can help enhance healthcare operations, shorten revenue cycle times, improve patient care and achieve an electronic medical record (EMR). 3M Health Information Systems is part of 3M Health Care, one of 3M's six major business segments. 3M Health Care provides world-class innovative products and services to help healthcare professionals improve the practice, delivery and outcome of patient care in medical, oral care, drug delivery, and health information markets.
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