3M Health Information Systems Selects Info-X Medical Necessity Content.

Business Editors/Health/Medical Writers

NORTHVALE, N.J.--(BUSINESS WIRE)--Oct. 21, 2003

Seeking to help hospitals decrease rejected insurance claims, Salt Lake City-based 3M Health Information Systems has selected Info-X Inc. to provide medical necessity content to its coding software. Info-X's content, which enables healthcare organizations to comply with Medicare's complex outpatient payment rules, will be embedded in a new 3M product.

The new product, 3M Medical Necessity Software, is integrated with 3M APCfinder Software, which supports coding and grouping of outpatient services under Medicare's outpatient prospective payment system. 3M Medical Necessity Software integrates charge detail and medical necessity edits with 3M APCfinder Software, making it possible to check Local Medical Review Policies (LMRPs) right at the point of outpatient coding.

Adhering to these policies, which vary by state and change frequently, can be critical to a hospital's financial health. The policies reflect Medicare's determination of "medical necessity," meaning whether a certain procedure is warranted by a given diagnosis. As a result of the enormous number of potential procedure and diagnosis code combinations however, staying abreast of the policies poses a major challenge.

"Health-care organizations are crying for tools to help with coding compliance," said Jerry Baker, president and COO of Info-X. "Hospitals and doctors want to comply with Medicare's fraud and abuse regulations, but the only way to do it is with a sophisticated automated tool."

The entire spectrum of health care delivery is subject to medical necessity regulations, Baker said. "The rules affect everyone on the health care continuum, beginning in the physician's office, on to scheduling and patient registration, through order entry, charge capture and coding, and finally to patient accounting, the business office and electronic claims submission."

To date, the majority of coding compliance tools available have been of the "claims scrubber" variety, added Carl Bertrams, senior vice president of business development at Info-X. Typically, financial services staff use these tools--often long after physicians have rendered care and coders have assigned documentation codes, Bertrams said.

"While 'back-end' coding validation is an important component of any compliance program, 3M's Medical Necessity Software, using Info-X technology, brings a new level of automation to coders in the HIM department," Bertrams says. "We are delighted to work with 3M to offer an integrated solution that will help ensure clean claims, reduce Medicare payment denials, and improve outpatient coding and billing compliance."

Info-X's database, which contains millions of diagnostic and procedure code combinations that are affected by the policies, will enable coders using 3M software to check for LMRP compliance at the point of outpatient coding.

"Increasingly HIM professionals are being asked to help correct outpatient claims that have been rejected due to medical necessity errors," says Nancy Larson, general manager, 3M Health Information Systems. "Manually addressing these errors after a claim is denied by the Fiscal Intermediary or after a claim is rejected by a billing scrubber is a time-consuming and expensive process. By offering coders a powerful tool for reviewing LMRP edits while they have access to the patient's complete documentation, we can help organizations reduce outpatient billing errors and improve the bottom line."

"We view this agreement as an indication of industry acceptance of Info-X's philosophy of streamlining the chain of events that result in insurance claims," Bertrams added. "Our relationship with 3M is designed to identify compliance issues earlier in the flow of health care financial information," he said. "Some 800 hospitals in the U.S. already use Info-X products to make compliance edits available by integrating them with scheduling, registration and other patient processing functions."

"We are extremely pleased to have the opportunity to work with 3M Health Information Systems," added Baker. "3M is well known throughout the health care industry as an innovator in coding-related software applications and has an outstanding reputation for the high quality of its products and services. We see 3M's selection of our content as a validation of the significant resources Info-X commits to securing, compiling, distributing and supporting these critical medical necessity solutions."

About 3M Health Information Systems

3M Health Information Systems, based in Salt Lake City, Utah, is a leading provider of advanced software tools and services that help health care organizations capture, classify and manage accurate health care data. Built on a foundation of more than 20 years of clinical, financial and administrative expertise, 3M products help ensure the quality of data, which drives an organization's ability to manage revenue, comply with regulations, improve quality of patient care and manage resources effectively. It is a division of 3M, a $16 billion diversified technology company with leading positions in health care, safety, electronics, telecommunications, industrial, consumer and office, and other markets. More information is available by calling 800-367-2447 or by visiting www.3Mhis.com.

3M is a trademark of the 3M Company

About Info-X, Inc.

Info-X is the leading source of medical necessity intelligence for U.S. healthcare providers. The company's commitment is the delivery of products that simplify compliance regulations and reimbursement issues. Info-X solutions combine state-of-the-art technology with the latest medical coding and regulatory compliance requirements, and can be seamlessly integrated into existing systems and workflows utilized by hospitals, physician groups, and diagnostic service providers. Info-X products and services include MedicalNecessity(TM).com, MedicalNecessity(TM) Dictionaries, EditEngine and Veri-Claim. They are used by over 800 hospitals and health care providers. More information is available by calling 800-299-1091 or by visiting the Corporate website at www.info-x-inc.com.