Passport eCare™ Orders Suite
The Next Generation in Clinical Order Protection
Payers continue to increase the complexity and number of payer policies and clinical decisions governing reimbursement, causing an increase in provider costs for managing the process and training employees. Providers cannot afford to risk reduced or no reimbursement, as payment responsibility cannot be transferred to the patient.
The Orders Suite helps hospitals, clinics and clinical service centers to comply with payer policies and clinical decisions and, therefore, receive full reimbursement for the clinical services performed. Orders are verified for all of these rules on the front-end, during scheduling and/or preregistration where success is greatest.
- Medical necessity
- Precertification
- Frequency validation
- Duplicity checking
- Age and gender validation
- Inpatient only procedures
- Likeliness of correct ordered procedure
- Correct coding and billing
This single-user interface to check any payer clinical requirements saves significant resources, so that staff can focus their time on delivering care and service to your patients.
Order Solutions:
OrderRite™ - is a single-user interface to submit, validate and manage precertifications, validate clinical orders against payer rules for medical necessity and frequency limitations, duplication orders (CCI), gender edits, (OCE) and much more - all without the need for redundant data entry. This precertification solution eliminates up to 80% of the labor and 99% of the uncertainty for precertification/pre-authorization, procedure frequency limits and medical necessity.
OrderChecker™ - Screens orders against CPT®/HCPCS and associated diagnosis codes against the Medicare LCD/NCD CCI, OCE, APC OIG rules and returns results in seconds, along with all patient documents (ABN, requisition, APC co-pay statement, etc.), eliminating reliance on manual and paper processes.
OrderSmart - Sends and receives electronic orders, connecting physician offices directly to hospitals, clinics, labs and other ancillary healthcare operations.
ClaimRite™ - is a batch process that validates that claims contain valid CPT and ICD-9 codes and that procedures pass the active Medicare and commercial rules/edits.
When implemented together, claim details are cross-referenced against the CPT and ICD-9 codes identified during the front end screening to produce Delta Reports identifying inconsistencies between the front and back ends.