Video: MediQuant Overview - HealthEdge Source
HealthEdge Source™ provides advanced, seamless integration with MediQuant for Medicare National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) edits, significantly streamlining claims processing. This integration minimizes rework and downstream efforts, ensuring a more efficient workflow.
Key Benefits of MediQuant HealthEdge Source:
- Comprehensive Medical Necessity Edits: Simplifies clinical policy maintenance and streamlines coverage determination and claims processing. These edits help health plans automate the process of identifying policy impacts on claims, reducing denials and provider abrasion, and helping ensure regulatory compliance.
- Automatic Updates: Similar to all third-party integrations in Source, updates are delivered automatically, and all maintenance is handled by the HealthEdge team.
- Customizable Policies: Policies can be tailored to meet specific health plan needs. Options include turning policies on or off, monitoring policies, adjusting dispositions, or carving out exceptions.
- Detailed Audit Trail: Provides all applicable edits for individual claim lines, not just the most severe. Live links on each MediQuant edit direct users to policy documents, helping provider queries and audits. The full rationale behind policies is available in the audit trail for transparency and clarity during reviews.
By leveraging these features, health plans can create an automated process that indicates policy impacts on claims, thereby optimizing efficiency and compliance.
