"Claims scrubbing" might sound like something that requires a bucket ofsoapy water and a good sponge, but for medical billing services andphysician organizations it's a valuable technology designed to reduceerrors and speed up reimbursement.
That's the attraction behind ClaimStaker, a claims scrubbing application offered by Tallahassee, Fla.-based Alpha II. Developed jointly by the MEGAS Corp. of Tallahassee and Montgomery, Ala.-based Unicor Medical, ClaimStaker is now being offered by Alpha II after a successful beta test.
Alpha II announced on Wednesday that CPU Medical Management Systems, aprovider of healthcare information software medical billingorganizations and physician practices, will integrate ClaimStaker withits MED/FM medical billing and revenue cycle management softwaresystem.
The contract follows an April beta test of ClaimStaker with MediNomics, a West Monroe, La.-based revenue cycle management firm.
"ClaimStaker gives our coders and data-entry staff the tools toscrub all claims against CCI edits, LCDs, NCDs and customized macrosand rules," said Patrick F. Lukacs, MediNomics' CEO. "Our clients notonly see faster reimbursement through reduced denied claims, but thedenials are now limited to complex coverage issues and requests frominsurance companies for paper records to support payment. We are notseeing denials based on medical necessity and inconsistent diagnosisdenials, which used to slip through and require rework on the backend."
Lukacs also pointed out that ClaimStaker will provide MediNomicsclients with coding education and awareness of reimbursement andcompliance issues.
Based in San Diego, CPU Medical Management Systems' software is beingused by more than 15,000 physicians nationwide and is billed as theleading software solution in the billing service market. The25-year-old company has signed contracts this year with AmericanBilling Services, Inc. of Portland, Ore. , Desert Medical Imaging ofIndian Wells, Calif. , Professional Business Services of Springfield,Ill. and X-Ray Professional Associates of Concord, N.H.
"Several of our clients specifically recommended that we considerinterfacing ClaimStaker with MED/FM," said Michael Stringer, CPU'spresident and CEO. "We're confident that ClaimStaker will help ourclients better serve their physician customers that are having problemswith medical necessity denials."
Founded in 1983, Alpha II Software Solutions was borne out offrustration with the ICD-9 database, leading to the launch a few yearslater of CodingSystem, an automated code search and edit software foroutpatient facilities. The company now serves more than 30 developerpartners and 30,000 healthcare providers.
"ClaimStaker has a demonstrated track record of helping practicesincrease revenue, reduce denials, meet compliance regulations andmonitor coding practices," said Marla Harmon, vice president ofoperations for MEGAS.
What medical billing issues are you finding to be the most difficult to overcome? What software works best for you, and which products aren't as good as advertised? Send your comments to Managing Editor Eric Wicklund at eric.wicklund@medtechpublishing.com.