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3M™ Medical Necessity Dictionaries

Expert content for medical necessity validation

Validating the necessity of medical procedures serves two purposes for a healthcare facility. First, it helps healthcare organizations stay compliant with stringent requirements. Just as importantly, it helps facilities reduce denials and achieve appropriate reimbursement for services rendered.

3M offers medical necessity edits and content to help clinicians and coders validate that medical procedures are necessary and appropriate before services are rendered. By operating throughout the revenue cycle, the 3M™ Medical Necessity Dictionaries can help minimize compliance risk and reduce denials, rework and payment delays.

In a pre-service environment such as a physician office, patient access, point of service, etc., the 3M Medical Necessity Dictionaries (for Medicare Part A and Part B) can be embedded within an existing health information system (HIS) to provide automatic medical necessity validation during scheduling and registration. 3M Medical Necessity Dictionaries can be embedded in the major HIS vendor systems, including McKesson, Cerner, MEDITECH, Siemens and Epic.

3M medical necessity edits and content are also available at the point of coding to the HIM department in these 3M applications:

For patient financial services and denials management, 3M medical necessity edits and content can be part of these 3M applications:

Features and benefits

Compliant with current regulations

Every month, 3M compiles, maintains and supports updates for Medicare Fiscal Intermediary (Part A), Carrier (Part B), Local Coverage Determinations (LCDs) and several Medicaid and private payer plans. This gives hospitals and business partners prompt access to regulatory changes.

Value-added functionality

When embedded in an existing HIS, 3M Medical Necessity Dictionaries can enhance the system’s capabilities with expert medical necessity functionality. The 3M dictionaries can provide automatic medical necessity validation during scheduling and registration and help eliminate the costly, time-intensive monthly tasks of gathering LCD/NCD information and performing manual reviews.



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