Medical Necessity
Don’t get stuck with an unpaid bill. Reduce claim denials, speed up reimbursement, and improve patient satisfaction with Medical Necessity, a denial prevention solution. Medical Necessity verifies during scheduling and in real time that a patient’s requested procedure or test CPT® code(s) matches the appropriate ICD-9 diagnosis code(s) provided by the physician to qualify for payments and reimbursement.
By verifying compliance for Medicare or other insurance carriers, you—and the patient—will know immediately who’s responsible for payment, leading to improved patient satisfaction and fewer A/R days.
Benefits:
- Reduces denied claims and increases revenues with automatic prompts to check for medical necessity
- Enables schedulers to focus more time on customers with functionality that allows staff to automatically generate Advanced Beneficiary Notices by e-mail or fax
- Educates physicians on approved procedure diagnosis codes