Put Through Wringer-washer" Pilot, Info-X Wins Major Contract

After conducting a rigorous three-month test, Buffalo, N.Y.-based Catholic Health System will adopt MedicalNecessity.com, an online service from Info-X Inc. The online service enables administrative staff at the four-hospital system to determine if Medicare will pay for certain procedures prior to delivery.

Put Through Wringer-washer" Pilot, Info-X Wins Major Contract

Northvale, N.J. (PRWEB) June 24th, 2003 -- After conducting a rigorous three-month test, Buffalo, N.Y.-based Catholic Health System will adopt MedicalNecessity.com, an online service from Info-X Inc. The online service enables administrative staff at the four-hospital system to determine if Medicare will pay for certain procedures prior to delivery.

Before we signed the contract, we put the Info-X system through the wringer-washer," said Theresa Siejak, billing supervisor at CHS. We wanted to see if the system would slow down patient flow and what kind of reports it would generate. We knew we had a problem with Medicare denials, but we needed a system that would facilitate physician education. Info-X measured up to all of our demands."

Prior to implementing MedicalNecessity.com, CHS was writing off nearly $1 million annually in denied outpatient Medicare claims, primarily for lab services, Siejak estimates. Physicians would order tests, but they were not supported by the associated diagnosis. Upholding Medicares so-called medical necessity" rules, which govern payment, proved difficult, Siejak said. Registration staff could not easily consult the rules. You need to check for Medicare compliance up front," she said. With MedicalNecessity.com, we can."

During the pilot, CHS tested the system in two departments at Mercy Hospital in Buffalo. Staff in the lab and the outpatient registration ran the system through its paces, entering patient data online at a secure Web site that accesses the Info-X software. Before registering a patient for blood work, a phlebotomist would check to see if the ordered tests were covered by Medicare," Siejak said.    

Using the system is simple, she said. A staff person enters a diagnosis and test codes from a pull-down menu that Info-X customized for CHS. Then the computer searches against Info-Xs database, which contains millions of code combinations that define Medicare coverage for all 50 states. The system alerts the user if the requested procedure is not covered. It will also print out an ABN, or advance beneficiary notice, form that alerts patients they may have to pay for the test.

One of the key benefits to the system is that we can explain to patients what Medicare will cover for them," Siejak said. Sometimes they assume Medicare will pay for everything. Now we can collect on services that we wound up writing off before."

CHS will roll out the MedicalNecessity.com service to each of its four hospitals during the remainder of the year. Even though the hospitals use varying billing systems, they can all use the Web-based service through pre-existing Internet connections--another Info-X plus, Siejak said.

"In designing MedicalNecessity.com, Info-X clinicians and developers carefully evaluated the hospital patient intake process with a goal of optimizing pre-service reimbursement information for users while minimizing workflow disruption," said Jerry Baker, president and COO at Info-X. "The fact that 150 hospitals have signed up for our web-based system in just over two years has validated these preliminary efforts. When approached by CHS to undergo an extensive pilot prior to their commitment to purchase, we were optimistic that the system would meet their expectations. In the end, the rigorous testing at CHS helped us refine the system. Their feedback proved invaluable to our ongoing efforts to improve MedicalNecessity.com . Customers purchasing the most advanced coding compliance technology expect the highest quality Medicare rules, along with the ability to process patients seamlessly with a high degree of flexibility and ease-of-use. We are very pleased to meet the high standards of CHS and successfully complete their pilot program."

MedicalNecessity.com is used by more than 150 hospitals nationwide. Info-X also provides a medical necessity database, which can be integrated directly into a hospitals information system. This software is used by over 500 hospitals.

Info-X announced the contract at the 2003 Healthcare Financial Management Association Annual National Institute and Idea Exchange Show. Info-X was among 280 exhibitors at the event.

About Info-X, Inc.
Info-X is the leading source of medical necessity intelligence for U.S. healthcare providers. The companys commitment is the delivery of products that simplify compliance regulations and reimbursement issues. Info-X solutions combine state-of-the-art technology with the latest medical coding and regulatory compliance requirements, and can be seamlessly integrated into existing systems and workflows utilized by hospitals, physicians, and diagnostic service providers. Corporate website: www.info-x-inc.com