MedNex Online

Welcome to the information place for MedNex Online, the source for your medical necessity needs

Source of Denials

• For most of our clients, the greatest source of denials, the one that is most preventable, are those for ancillary tests and studies ordered at the point of service or by the referring physician office.
• Almost all of our clients have set up Revenue Cycle/Reconciliation Teams to better understand the type of denials and source. The teams, many of which we have set up, help sort out the administrative problems from those directly caused (not intentionally) by the ordering Medical and or house staff.
• Denials persist because we haven't put tools into the hands of physicians or their office staffs that are easy to use. We have learned that the attending staff do not want to be responsible for causing the loss of revenue to the hospital and yet it happens.
  • We spend incredible amounts of energy and staff time to overturn denials or sometimes we don't even bother. Even when we are successful, we are affecting cash flow.

Reduce and Eliminate

• Educate the medical staff; educate their office staffs. If it is done well, it raises consciousness and generally improves performance. But it doesn't always last.
  • Physicians practices find it difficult to transition from Diagnoses they use on their superbill to the more fine tuned Diagnoses required for Medical Necessity.
• The Medical Staff need an interactive tool that is easy to use, educates, can be used in any setting and can provide patient specific screening . It is one thing to know if a test is considered Medically Necessary it is another to know whether specific patient qualifies pursuant to frequency requirements.
• Is there such a tool that physicians can literally carry around like their Palm Pilots and still be available to their office staffs?
• Health Systems Management Network, Inc after doing hundreds of consulting assignments for both facilities and physician practices have designed a Medical Necessity Tool whose specifications were written by our clients.
• Mednexonline evolved from a consulting engagement in which our laboratory client needed to have over 5,000,000 tests checked before they could be submitted for payment.
• HSMN was recently asked by a client if we could put our logic on a handheld device for use by medical, house and other staff members.
• Health Systems Management Network is now offering our Medical Necessity tool to other clients. For more information and for a peak at Mednexonline, Call us at 877-857-4534 or Click Here to see a video of this application in action.