MedAptus awarded U.S. patent for "Method and System for Processing Medical Billing Records"

Jul 2 2010

MedAptus®, the market leader in charge capture technologies, announced today that it has been awarded U.S. patent number 7,685,002 entitled "Method and System for Processing Medical Billing Records." The patent pertains to MedAptus' automated process for completely and accurately capturing both professional and facility charges in outpatient settings. More specifically, this patented process, incorporated within MedAptus' Facility Edition software solution, maps procedural codes to hospital charge data master files, translates rendered professional charges into facility charges, assists in the determination of the appropriate level for a facility visit charge, and supports back-end charge reconciliation.

The MedAptus Facility Edition provides hospitals and integrated delivery systems with the ability to actively and comprehensively manage technical charges. While outpatient services are growing in scope and importance to the hospital bottom line, they continue to involve manual processes, within a silo, at most institutions. Typical struggles for these centers include paper-based coding and billing processes, complex split-billing workflow, lack of back-office reconciliation transparency, and/or consistent evaluation and management (E&M) code leveling. MedAptus developed its patented solution to directly address these commonplace market challenges.

While many provider-based institutions have made good progress in adopting paperless clinical processes, encounter forms to support billing processes often remain and can drain administrative and management resources. Eliminating this manual workflow can result in substantial productivity gains. In fact, one internal study conducted by a MedAptus customer revealed that usage of Facility Edition reduced the effort for charge capture and related documentation from anywhere between five and 90 minutes per encounter to less than ten seconds per encounter.

Facility Edition can be implemented as a stand-alone system, or in conjunction with MedAptus' Professional Intelligent Charge Capture tool. For organizations that use MedAptus for capturing and processing both the physician and clinic charge components, an embedded Cross-Reconciliation Engine drives additional financial enhancement and compliance. An automated analysis of entered charges identifies any potentially overlooked opportunities prior to claims creation and submission.

Another benefit of Facility Edition is its ability to compute consistent technical/facility E&M levels. Since the Centers for Medicare and Medicaid Services (CMS) has limited formal guidelines around E&M code leveling, individual hospitals are expected to develop and follow their own internal guidelines consistently across departments and according to general CMS coding principles. Facility Edition yields both technical coding consistency and compliance, reducing the risk associated with RAC audits.

"Complex, shifting and sometimes vague regulations combined with limited visibility between the professional and facility revenue cycles cause needless revenue loss and compliance worry for many institutions. This is why MedAptus created a targeted technology solution - to provide intelligent, automated and integrated management of provider-based clinic revenue. We are thrilled that our novel approach to accomplishing facility charge capture automation has been recognized with a patent from the United States Patent Office," stated David Delaney, MD, MedAptus' Chief Medical Officer. "This patented process exemplifies MedAptus' commitment to leadership in point-of-care charge capture technologies across the healthcare continuum."