Data Sheet: Efficiently Verify Medical Necessity with MediQuant and Source
Ensuring accurate documentation to support medical necessity remains a significant challenge for healthcare providers and payers.
Ensuring accurate documentation to support medical necessity remains a significant challenge for healthcare providers and payers. Incorrect claims documentation often leads to denials, rework, and increased costs. MediQuant® and HealthEdge Source™ (Source) address these issues by integrating advanced medical necessity edits within a streamlined interface, ensuring compliance with CMS National Coverage Determinations (NCD) and Local Coverage Determination (LCD) policies.
Key Features of MediQuant and Source Integration:
- Comprehensive Content Library: Includes procedures, diagnosis codes, frequency limitations, and commentary on rule changes.
- Seamless Workflow: Source incorporates third-party solutions, synchronizes content updates, and manages administrative overhead.
- Regulatory Compliance: Ensures adherence to CMS policies, reducing the risk of unlawful or inappropriate prescribing.
Benefits:
- Reduce claims denials
- Ensure regulatory compliance
- Minimize provider abrasion by letting medical necessity guide the care provided
- Better manage utilization across virtually all care settings, including hospitals, physical offices, labs, and imaging centers
For healthcare providers and payers, leveraging MediQuant’s medical necessity content through Source leads to better payment accuracy, compliance, and operational efficiency. Learn more about how this integration can benefit your health plan by visiting the Source third-party integrations page on the HealthEdge website.
