Physicians now have a way to check to see if treatments will be covered by insurance through a new personal digital assistant-based application, ClearCoder(TM).
MDeverywhere(TM), a leader in providing handheld solutions for physicians to improve efficiency and accuracy at the point of care, developed ClearCoder as a reference tool for the cumbersome Local Medical Review Policy rules set. ClearCoder's effectiveness was validated by a recent independent return on investment (ROI) study completed by Superior Consultant Company, a national healthcare management and technology consulting firm.
The ROI was performed in the pre-operative surgical department at a large teaching facility in the Southeast where 13 physicians utilized MDeverywhere's ClearCoder. Benefits realized by the department include a reduction of rework claims from 1,219 to 813, resulting in a savings of $7,808 per physician.
"Many insurance companies only pay for services that are considered medically reasonable and necessary," says Alan Rubin, president and CEO of MDeverywhere. "Conceptually this makes sense, but the complex policies put a great burden on doctors to ensure they have chosen the right course of action and documented it properly for insurance reimbursement. To fall short of that will invariably result in a denied claim. The ClearCoder product eliminates the gamble and as a result continues to build on our core expertise of delivering strong financial value to healthcare institutions."
ClearCoder offers doctors two ways to quickly determine whether a treatment is considered medically necessary. Clicking on a CPT(R) procedure code displays all of the diagnoses that can be treated with the procedure. Clicking on an ICD9 diagnosis code displays all of the procedures that can be performed to treat the illness.
Because of its ease of implementation and strong financial return, MDeverywhere considers ClearCoder an ideal way to drive physician adoption of its core charge capture product, EveryCharge(SM). MDeverywhere plans to market ClearCoder to hospitals and large group practices across the United States.
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