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From
the chaos of forms, paperwork, busy signals, phone messages and
potential miscommunication, a new and powerful method of sending and
sharing vital medical information has emerged.
Wybtrak, Inc.
has developed Medicom in order to minimize your efforts and give you a better way to track and
manage these requests. The
Problem The process of obtaining prior authorization for procedures and/or referrals is time-consuming, tedious and prone to errors. Historically, a nurse would be on the telephone with the insurance company to verbally relay the patient information, provider information and medical information to a clerk at the insurance company. Manually gathering the charts and reading the information to the insurance clerk could tie up a nurse for hours of each day. More recently, the insurance companies have allowed the provider's staff to fax the information to them, but only on the insurance company's own form. This still requires the referral nurse to gather the information, manually transcribe it to the insurance company's form, carry it to the fax machine, and dial (and re-dial) the insurance company to send the fax. Finally, they must manually file away the paperwork so that it can be found again at a later date. As if this weren't enough, they must still manually flip through the paper patient records to see which ones are overdue for authorizations. The
Solution Medicom
users can create a database of information on patients that can be
accessed using state-of-the-art computer and communication technology.
Medicom
allows the user to enter patient information into the request form
on-screen. The information
entered is stored in a manner that will allow it to be retrieved at any
time. The patient
demographic data and any associated Prior Authorization or Referral
Request data will automatically fill in the fields of a new form if an
existing patient is selected. Medicom will also transfer any electronically stored information as a file attachment, such as office notes and diagnostics tests. These documents can be easily scanned into the Medicom system so the search for patient to recover notes, lab results, etc. is a time consuming issue of the past...these documents are now just a mouse click away.
You
can literally manage the prior-auth and referral processes from
the convenience of your computer. With one click of a
button, you can submit your authorization/referral request forms.
Upon entering the authorization number on-screen, the form can
then be forwarded to the facility where the patient is being referred
to, i.e. another physician, hospital or diagnostic center.
This eliminates the need for any phone calls between providers,
provider facilities and/or managed care agencies. The latest ICD-9 and CPT codes are built into your Medicom system so identifying the right code and writing out the accurate description is as simple as selecting from an on-screen, drop down list. Once
a form has been transmitted, the critical issue becomes that of
management. How does one
keep track of all the requests that have been sent?
Medicom
will keep track of it for you. Print
a report to see which requests are new, sent, pended, denied, approved,
open or closed. Medicom
will then automatically send a report to the utilization management
company requesting a follow-up for all “open” cases that are listed. The
built-in audit trail capabilities is your guide to full
prior-auth/referral full process accountability…the answers are at
your fingertips. The quick, easy and
accountable proof will reduce denials, improve billings and strengthen
your bottom line. The importance of chronologically tracking prior authorization requests is critical in delivering heath care on time and on target. Print a “sort by date report” to view the sent requests so the oldest requests can be identified and followed up with before the date of service. Your
patients will appreciate having procedures and tests done on the date
that it was originally scheduled as much as you will enjoy sending these
requests via Medicom. For more information, please contact us. |
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