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 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.
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.
Identify and Eliminate Denials
DEnial Monitoring and Management
Our "Denial Montoring Service" allows you to "see" denial trends on an interactive Denial Dashboard.
- Denial Alerts - Automatically sends client specified denial trends by HCPCS, DRG, Reason, Medicare Policy and more.
- Custom Alerts - We create custom client specific reports delivered by email at your specified intervals.
- Denial Dashboard - Interactive analitics allows you to quickly identify new denial trends, compare denied services by payors, reason and much more.
- Denial Reporting - Pre-defined and client customizable reports that can be export to PDF, Excel, CSV, and Word.
- Denial Charting - Pre-defined and client customizable charts that can be exported to PDF, Excel, CSV, and Word.
- Automatic Daily Monitoring - Extracts and stores key denial data from your electronic remittances for all payors.
- A Multi-Provider and Multi-Payor Solution - Perfect for Health Systems who wish to monitor denials for all of their provider and payor types.