Also Available Integrated with MEDITECH MAGIC

Simple, fast, clean and easy-to-use, Insight Medical Necessity will quickly become an invaluable tool throughout your organization, from admissions to order-entry to medical records to external practices; everywhere your team needs instant access to medical necessity requirements for any payor. With easy access to medical necessity policies for every U.S. payor—including all government, commercial and non-profit payor organizations—your staff will also be much more effective in working with providers to ensure that the appropriate diagnosis was obtained.

True All-Payor Coverage

Insight Medical Necessity delivers the most extensive set of payor medical necessity requirements available today. With coverage for every state, federal, non-profit and commercial payor in the U.S., no one can match the depth and breadth of our content. With a team of revenue-cycle experts constantly updating our hosted systems with the latest changes, our clients are assured of using the most complete and up-to-date medical necessity data available at all times.

Automatically Generates Medicare ABNs and Commercial Notices of Non-Coverage

For patients whose services are not covered, the system automatically generates the required ABN or waiver form so that the patient can acknowledge that they are responsible for paying the claim. The system automatically issues ABNs and patient responsibility waivers using up-to-date CPT, HCPCS and ICD-9 code tables in a date sensitive format. ClaimTrust even links directly to your Chargemaster (CDM) file to reflect actual pricing in the ABN.

Access to Local Coverage Determination Policies

With Insight Medical Necessity, your staff has easy access to up-to-date Local Coverage Determination policies (LCDs). Physician offices Medical Records departments can especially benefit from faster access to the latest LCD policies instead of having to go through the fiscal intermediaries.

HIPAA 5010 and ICD-10

The deadlines for HIPAA 5010 and ICD-10 will be here before we know it. Providers will be required to submit transactions with 5010 on Jan. 1, 2012, and convert to ICD-10 by Oct. 1, 2013. ClaimTrust will be ready to test HIPAA 5010 transaction sets and ICD-10 codes well ahead of these deadlines and will offer concurrent support for the 4010A and ICD-9 during your transition. If you have any questions about our transition to 5010 or ICD-10, please contact info@claimtrust.com.