Medical Necessity Solutions Designed for How Medicare Pays Today
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Today’s outpatient Medicare payment system is complex and it is changing rapidly. Each year, an increasing number of services that were once paid individually are now packaged into one payment.This unpredictable payment logic leads to larger outpatient denials because packaging places a premium on key procedures. |
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Prospective Payment System Medical Necessity Our solution prevents real denials because it is designed for how Medicare pays today. Our Medicare experts integrated the outpatient payment system into its design so that your staff:
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Delivering Solutions Since 2001
LMRPManager, LLC was founded in 2001 by two healthcare industry executives, who manage our sales and operations to this day.
LMRP is an acronym for "Local Medical Review Policy". LMRPs are now know as LCDs (Local Coverage Determinations) and NCDs (National Coverage Determinations). LCDs and NCDs are the primary building blocks of our medical necessity solutions. Our staff monitors and manages these policies on a continuous basis for use in our web applications and medical necessity data tables. We use no outside support for policy processing which allows us to quickly provide service for our clients.
Today, we service hundreds of hospitals nationwide ranging from individual community hospitals to many large multi-hospital health systems.
We are proud to have three of the ten largest hospitals in the country and four of the top 25 as clients. All four have a large percentage of Medicare patients and they rely upon our LMRPManager and RACManager services. In addition, all have been clients for over 12 years now.
Our business prospers by providing our clients with great solutions and super responsive support. We are especially proud to help our clients apply "Best Practices" regarding challenging Medicare issues.
Please Email Us for more information or call 1-407-841-5677
LMRPManager, LLC
PO Box 360322
Melbourne, FL 32936
Data for Your Informaton Systems
MEDICAL NECESSITY DATA
The affordable way to eliminate the task of gathering LMRP, LCD, and NCD data yourself.
Medical Necessity Data Tables for your HIS are complete tables of thousands of CPT™/HCPCS procedure codes with supporting ICD diagnostic codes which will populate many existing Hospital Information Systems (HIS) that already have basic medical necessity checking capabilities. These systems just need the necessary Local Coverage Determinations and Laboratory National Coverage Decisions rules to become useful.
Our Medical Necessity Data Tables feature:
- Weekly or Monthly Updates - Your Choice
- Audit Trail - Shows the changes for each update
- Matched Data - Data Tables are extracted from our Medical Necessity Applications database.
- Custom Formatting - Works with all HIS that have upload utilities
- Competitive Pricing
- Accountability - We don't resell data from someone else. Nothing is outsourced.
Let Us Provide Extra Assistance and Support
| cONSULTING SerVICES |
Establishing clear policies and procedures is an essential step when implementing a Medical Necessity/ABN solution.
Our "Best Practices Approach" focuses on improving the detailed processes as they pertain to Medical Necessity, Compliance, and Revenue Cycle Management.