With one-click, save time and money!
ClaimStaker Claim Scrubbing EHR & Practice Management With one-click, save time and money! Reduce denials and increase reimbursement using the industry’s leading claim edit database! Diagnosis Code Edits ICD-9 validity o Ultimate specificity o Secondary code suitability o Patient gender E-codes V-codes Procedure Code Edits CPT validity, including patient gender and age Correct Coding Initiative (CCI) bundling HCPCS validity RVU sequencing Modifier usage Global fee periods PQRI ePrescribe incentives Outpatient Prospective Payment System (OPPS) Edits Outpatient Code Editor (OCE) validation Revenue/HCPCS code combinations Condition Code, Occurrence Code, and Value Code checks Medical Necessity Edits Part A and Part B LCD/NCD Proprietary (Clinically Defensible) E&M level of service Links to LCD/NCD policies Claim-Level Technical Edits NPI (provider number) validity Accident indicators/date accuracy Place of service appropriateness Charge versus allowance analysis Overall proper claim completion File Format Edits ANSI 837 EDI claim file format verification Situational segment and data element evaluation Maximum/minimum field lengths Proper qualifier usage Data content accuracy ClaimStaker… Improves claim validity Improves cash flow Demonstrates clinical defensibility Payer Specific, Customizable Edits » » » » » Enable or disable edits for specific claim types or payers with the click of a check box Accommodate unusual insurance and managed care rules Customize edits by individual payers or payer types Create your own rules using the “edit wizard” E&M, eRx, and PQRS Edits » » » » » Apply an acuity level to each ICD-9 code Avoid compliance risks of over-coding Prevent revenue loss from under-coding Assists with capitalizing on eRx and PQRS incentives View only the applicable PQRS edits to your practice Detailed, Instructive Error Reporting » » » Informs you of all the information necessary to make coding corrections Presents the error logic in easy-to-understand terms Provides the appropriate corrective action when possible Data Strategies, Inc. CORPORATE SALES (800) 875-0480 Fax: (858) 486-5492 [email protected] 13475 Danielson St., Suite 210 Poway, CA 92064-8858 www.MDsuite.com TECHNICAL SUPPORT (800) 514-3131 Fax (858) 486-5493 [email protected] ClaimStaker Claim Scrubbing EHR & Practice Management How does it work? 1. 2. 3. 4. In post charges, you click the ClaimStaker button. Information for all charges is sent via a secure internet connection to be analyzed by ClaimStaker. Results are then displayed – click on any item to immediately correct any errors – PRIOR to billing! Links are provided for errors so you can read detailed information. Where in MDsuite can I scrub my claims? Currently, this functionality is available in the post charges screen. Future 1. 2. 3. versions of MDsuite will allow you to scrub claims in more areas. Pre-processing report during billing EHR encounters “Leave for Coder” Is any personal health information sent to Alpha II ClaimStaker? No – individually identifiable health information is not provided. How much is it? The fee varies according to how many providers use it. practice. Consult with your Sales Representative for pricing for your How is a “provider” determined? A provider is defined as an individual who performs services, i.e. the rendering provider. How am I billed for this? The fee is per provider, per year. It is billed with your annual Software Maintenance Fee. The annual fee will be prorated based on when you elect to add the feature. Should I buy it? For most offices this is a simple decision – YES! The price is minimal and the saving potential is HUGE! What is clinical defensibility? Alpha II had a medical review board made up of doctors and nurses, go through all CPT and ICD9 codes to create logical rules for medical necessity for non-Medicare payers. Data Strategies, Inc. CORPORATE SALES (800) 875-0480 Fax: (858) 486-5492 [email protected] 13475 Danielson St., Suite 210 Poway, CA 92064-8858 www.MDsuite.com TECHNICAL SUPPORT (800) 514-3131 Fax (858) 486-5493 [email protected]
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