3M content for medical necessity validation
Avoid costly claim denials and delays
No matter what you call it—reasonable and necessary, appropriate level of care, or right care in the right setting—medical necessity is often the defining cause for a claim denial. Uncompensated medically unnecessary services total billions of dollars per year. Without accurate medical necessity checking and validation, your reimbursement could become entangled in those denials…and keep you from complying with regulatory requirements.
We can help you avoid the risk of denials, rework and non compliance. Our medical necessity content lets hospital staff validate claims for medical necessity at any point in the revenue cycle:
Features and benefits
Put it on your calendar
Every month, 3M delivers content updates for Medicare Fiscal Intermediary (Part A), Carrier (Part B), Local Coverage Determinations (LCDs) and several Medicaid and private payer plans. This gives facilities prompt access to regulatory changes.
Automated and efficient
When embedded into any system in your revenue cycle, 3M medical necessity content can enhance the system’s capabilities with automated medical necessity checking in any workflow. It can help you realize the full benefit of your hospital system by eliminating the costly, time-intensive tasks of gathering LCD/NCD information and performing manual reviews.
3M has a skilled team of subject matter experts, including RNs, nosologists, and medical necessity specialists, that produce our content. These experts not only have deep clinical and industry knowledge, but are committed to creating the most extensive medical necessity and coding compliance rule set available.
Planning for the future
We’re looking toward the future by including ICD-10 content now. Both the 3M Medical Necessity Software and 3M Medical Necessity Dictionaries allow you to test and prepare for ICD-10: They include the most current edits for Medicare LCDs and NCDs, including rules based on ICD-10 codes.