A web-based software application that validates medical necessity, Medessary is the most up-to-date and comprehensive solution available. You access Medessary through a secure website, https://www.medessary.com/.
Stay up-to-date with medical necessity
While other companies update their systems quarterly, we update all the medical necessity rules issued by CMS every week. When a critical update or correction is issued, we will update the same day so you won’t have to wait.
Our updates are comprehensive. They include all changes in Local Medical Review Policies (LMRPs), Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs), Outpatient Code Editor (OCE) edits, Addendum B codes, and Correct Coding Initiative (CCI) tables.
Avoid lost revenue due to medical necessity denials
You lose money by failing to issue Advanced Beneficiary Notices (ABNs). Medessary automatically generates both general and lab ABNs for procedures that fail medical necessity. Medessary also generates statutorily non-covered forms and identifies frequency limitations and inpatient-only procedures. Regain your lost revenue by always knowing when you need an ABN, and whether or not your CPT and ICD-9 codes are medically necessary.
Access Medessary online
Claimtrust is an Application Service Provider. Absolutely no on-site installation, maintenance, or implementation is necessary. All you need is an Internet browser, a username, and a password. This product is secure and 2007 HIPAA compliant.
View real-time reports
Medessary Transaction Tracking allows you to view your staff’s activity in a real-time environment. This means that if your staff checks for medical necessity at 2:15, you will be able to view a report on that activity by 2:19. An “Existing ABN” finder allows you to track issued ABNs. These electronic records allow you to quickly discover who is not checking for medical necessity and which patients have received ABNs.
How Medessary works—
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The staff submits a procedure (CPT) and diagnosis (ICD-9) to Medessary.
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Medessary processes the procedure and diagnosis against medical necessity rules.
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Medessary returns a result of pass or fail. Any applicable LMRPs, LCDs, NCDs, or statutorily non-covered claim forms are immediately available to print. If the claim failed, Medessary provides an explanation for the failure of medical necessity and produces an ABN.
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