Product

Access Integrity®

 

An astonishing 30% of medical claims are rejected on first submission. The more claims are rejected, the more likely an organization will be targeted for an audit. Access Integrity reduces claim denials and reviews and increases cash flow and staff productivity.

Access Integrity takes an innovative approach to medical record analysis by combining six major functions:

  • Code integrity rules for ICD-10, CPT®,  and HCPCS
  • Governance mapping
  • Validation and cross checking
  • Enriched content mapping solution
  • Machine Aided Indexing
  • Natural language processing

Comparing these key data sets provides a detailed evaluation of each record, including:

  • All salient patient information
  • Key medical facts & taxonomy
  • Procedure notes
  • Claim Submission Form

This produces a highly accurate medical claim that has been thoroughly reviewed prior to submission, resulting in a significant reduction in claim denial and review and increased cash flow and staff productivity. Access Integrity allows health care organizations to focus on providing high-quality healthcare services to their patients.

Multiple Code Data Sets Automatically Checked

Access Integrity checks each submission and produces detailed reports in seven specific areas:

  • Code set and modifier validation
  • NCCI verification
  • Correct fee capture
  • LCD/NCD compliant usage
  • Medically Unlikely Edits (MUE)
  • Form 1500 data element compliance
  • Correct RVU
  • Global period eligibility

 

  Customer Value Proposition

 

  • Search and analyze medical records, including provider and procedure notes
  • Web-based cloud storage/access to all medical transactions
  • Real-time database updates
  • No installation or initiation fees
  • All-inclusive application…. no add-on modules or transaction charges
  • Simple, easy-to-understand annual subscription pricing