|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.
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:
LMRPManager specializes in Medical Necessity/Advanced Beneficiary Notice (ABN) applications, Medical Necessity Data services and Denial Management.
We are very proud to support a national client base of Health Systems and Hospitals. Our Medical Necessity/ABN applications are robust, accurate, and provide more functionality than anything else available. Our Medical Necessity Data Tables are a perfect match for any HIS system that needs accurate and up to date Medicare CPT/ICD codes.
We invite you to learn about our company, solutions, and services.
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:
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.