New billing software lets providers analyze denials

Thursday, September 30, 2004

PALM CITY, Fla. - Discovering systemic error patterns is the surest way to reduce Medicare claims denials and a new software program is designed to give providers a window into that process.

Currently in beta testing phase, Connectyx Technologies’ MRN Manager will debut at the Medtrade Show in Orlando, Oct. 26-28, with demonstrations at the Connectyx and Fastrack Healthcare Systems booths. Plainview, N.Y.-based HME billing systems vendor Fastrack recently agreed to co-market the software.

Connectyx President Ronn Schuman says he drew on 25 years of HME experience to create the MRN Manager, a program he contends is the latest advancement in billing software. A “knowledge-based” system that is “back-end driven,” the Connectyx product collates claims denials into various views and perspectives based on the user’s preference. Sophisticated graphics create what Schuman calls “the daily dashboard,” a presentation that includes an electronic replica of the Medicare Explanation of Benefits (EOB) form and three-dimensional charts detailing specific reasons for each denial.

Giving senior management instant access to the reports cuts through the communications delays that typically hamper the claims review process, Schuman said.

“Traditionally, senior management has been held hostage waiting for billing people to supply information,” he said. “With the old legacy systems, there used to be a stack of documents that needed to be sorted and analyzed. By intercepting the information directly from Medicare, managers can get their daily numbers and form an action plan without having to call up the billing department. If the work report says there are 15 patients with denial code ABC, they know where to go and what to do.”

Fastrack President Spencer Kay says he signed on to be a co-marketer of the MRN Manager because it augments his company’s billing systems.

“I like the capability that it offers the provider to focus in on problem areas with claims submission and make adjustments,” he said. “Providers will see real benefits with this.”

One provider already in tune with the benefits is Keith Trowbridge, former president of Liberty Medical Supply. The Port St. Lucie, Fla.-based provider of diabetes supplies is one of the largest Medicare billers in the United States.

“MRN Manager offers HME companies the ability to better understand why claims are being denied, thereby allowing both short- and long-term corrective actions to be taken,” he said. “By doing so, DSO drop and cash receipts are accelerated. It’s a terrific and much-needed management utility for monitoring Medicare remittance.”