What
is
it?
An
integrated
software
solution
that
determines
if
medical
procedures
meet
medical
necessity
requirements
in
accordance
with
both
the
National
Coverage
Determination
(NCD)
rules
as
well
as
the
Local
Coverage
Determination
(LCD)
rules
as
determined
by
the
following
CMS
appointed
Medicare
Carriers
and
Fiscal
Intermediaries:
- National
Government
Services
(NGS)
for
Medicare
Part
A
- TrailBlazer
Health
Enterprises,
LLC
for
Medicare
Part
A
- Wisconsin
Physician
Services
(WPS)
for
Medicare
Part
A
&
B
Why
do
I
want
it?
- Minimize
claim
denials
- Increase
collections
and
cash
flow
- Obtain
accurate
determination
of
patient
co-pay
and
deductibles
- Accurately
set
patient
coverage
expectations,
thereby
enhancing
overall
patient
satisfaction
and
minimizing
the
risk
of
uncollected
balances
- Reduce
patient
billing
- Enhance
staff
productivity
by
avoiding
manual
verification
How
does
it
work?
At
Point
of
Registration
eCare®
Online
Medical
Necessity
is
an
Internet-based
solution
that
allows
you
to
choose
procedures
and
diagnosis
from
customizable
lists
and
evaluate
them
against
local
and
national
Medical
Necessity
rules.
If
a
procedure
does
not
pass,
an
ABN
can
be
generated.
At
Point
of
Order
Entry
For
Hospital
Information
Systems
that
have
Medical
Necessity
checking
built
into
Order
Entry,
Nebo
offers
monthly
data
files
at
a
fraction
of
the
cost
of
other
vendors.
At
Point
of
Billing
eCare®
CMS
Claims
Management
includes
Medical
Necessity
as
part
of
our
comprehensive
list
of
claims
edits,
ensuring
that
a
claim
will
not
go
out
if
it
does
not
meet
criteria.
An
interface
from
the
Point
of
Registration
system
reconciles
ABNs
to
the
final
claim.
At
Point
of
Care
Our
electronic
physician
order
component
(eOrders)
allows
the
physician
to
place
an
order
online
and
check
medical
necessity
while
the
patient
is
still
in
the
office.
The
order
is
stored
in
a
secure
repository
and
immediately
available
for
retrieval
by
the
hospital.
How
do
I
get
more
information?
Send
an
email
to
info@nebo.com
Call
Nebo
Systems
at
630-916-8818
