[MT-L] Meditech medical necessity process through scheduling- additional questions
Gibson, Sharon
Hi there- I have additional questions on this- how are you handling exams that have exploders built for exams where each explodee requires medical necessity?
Do you have any exams where some or one of the explodees requires medical necessity but another does not and if so, how are you doing the ICD9 load in the billing requirement dictionary so that medical necessity is checked appropriately for both exams?
I know this is a known issue with Meditech so just curious if you have a work around that you would share. Thanks!
Sharon Gibson RTR
RIS Supervisor, Radiology Department | Augusta Health
P.O. Box 1000 | 78 Medical Center Drive | Fishersville, VA 22939
(540) 332-4427 Office | (540) 887-7999 Pager | www.augustahealth.com
From: Gibson, Sharon
Sent: Thursday, August 07, 2014 9:57 AM
To: medit...@mtusers.com
Subject: Meditech medical necessity process through scheduling
Hi all- we are in the process of going live with medical necessity through the scheduling module and I have a few questions, if anyone can help.
1. How are you handling appointments/ orders for ABN’s that have exploders attached where only a specific code in that exploder requires the medical necessity? Currently the ABN pulls the name of the test but quotes the price of all exams, not the one needing medical necessity. Meditech tells us they are working on this but was looking for any work arounds anyone might have.
2. How are you handling your ABN process for signatures? Scheduling prompts you as to whether the ABN is signed, which it would not be at scheduling. When the patient presents, how are you going back in the system to change that response to the appropriate signed response?
3. We have a process for CT exams where the patient is scheduled for an exam, comes in and gets kidney function testing prior to the exam and then we have to change the order to a without contrast due to poor kidney function. How are you handling the process to change the ABN?
Thanks in advance!
Sharon Gibson RTR
RIS Supervisor, Radiology Department | Augusta Health
P.O. Box 1000 | 78 Medical Center Drive | Fishersville, VA 22939
(540) 332-4427 Office | (540) 887-7999 Pager | www.augustahealth.com
Rhonda Stevens
If you have exploders that require medical necessity, you will need to add the parent code in the Medical Requirements dictionary with the Ask for Dx prompt set to “Y”. Then, when the parent code is ordered, the system will check the exploders that are attached and check for Medical Necessity as needed.
Rhonda Stevens
Lead Consultant
Navin, Haffty & Associates
1900 West Park Drive, Suite 180
Westborough, MA 01581
Cell: 331.452.5911| Corp Office Phone 781.871.6770
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