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NANO MED (MRE)
NANO Medical Edits & Necessity Services
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NANO MED (MRE) Medical Rule Engine
Standardized by doctors of current clinical practices, specialty society guidance, and industry-certified coding.
NANO MED(MRE) guarantees healthcare providers compliance with conventional medical coding. It practices clinical validation by a team of qualified nursing and medical coding experts to recognize claims for potential billing errors.
NANO MED is based on a thorough review by doctors of current clinical practices, specialty society guidance, and industry-standard coding.
NANO MED furnishes highly-performing medical coding & billing process for ICD-10-CM, ICD-10-PCS, CPT, and HCPCS, ICD 9-CM Code Sets; it additionally extends precise coding information so medical coders can resolve edits through the coding process or question physicians for clarification, reducing coding delays and medical necessity failures which may warrant as plausible, compelling, and relevant, based on evidence-based clinical standards of care.
Medical Claim Scrubber
A comprehensive medical claim scrubber and validation engine for medical claim forms. Helps in scrubbing and validation of medical claims. Avoids coding oversights and keeps one step ahead of denials before submitting claims to the payer. It directs to seek medical claims for faults and omissions that result in Payers’ denial or underpaid claims.
Claim Processing Management
Leverages automation features for hospitals and medical clinics to resolve or prevent any hurdles that can potentially disrupt the claims processing and billing workflow. Offers proper healthcare claims management with medical billing provision, revenue cycle management, and comprehensive medical practice management for payers, healthcare providers, and insurance providers.
Medical Necessity & Cross-Coding Edit Management
Offers medical code bundling, mutually exclusive coding, and duplications, maximum allowed frequencies, services relationship errors, and encounter related edits.
Payer Denials Management
Offers a compliance library for analyzing denial trends to uncover emerging trends by insurance carriers and redesigning or re-engineering the process to limit or lessen the risk of likely claim denials. Performs a thorough root-cause analysis and decides on the right solution for fixing the particular issue, helps to take corrective action, and submits the claim for payment.
Regulatory Compliance
Compliance with international medical classification with the world health organization. Medical codes meet the requirements of each regulator and cover over 36+ countries across the world. Ensures compliance with regulatory requirements based on the standard edits of (AR, CMS, ANA, ALIMA, etc.), ICD-CPT, ICD - HCPCS, ICD - CDT, ICD - DDC, ICD - ADDC.
Financial Analysis
Supports you in enhancing your financial performance through change management, business process improvement, and innovative technology—partners in preventing fraud and abuse within the system and ensuring that regulatory compliance requirements are met. Quick improvement in the provider billing revenue cycle to prevent fraud, waste & abuse.
Tariff -Contracting and Pricing
Ensures fair pricing of your provider contracts to maximize your revenue potential, cut costs and achieve a sustainable market positioning.
Clinical Content Information and Drug Monographs
Offers specialty-focused clinical information that easily transforms any HIT system into a comprehensive reference tool for healthcare professionals.
