Hello~ We have encountered a problem when checking MN. Medical Necessity in MAGIC is checked based on the patient's insurance. So, whether Medicare is primary or secondary, MN is checked by the system. In C/S, Medical Necessity is checked based on Financial Class, not by individual insurance. If Medicare is secondary, MN is not being checked. Because we are a mixed platform, and our patients are admitted through MAGIC ADM, sometimes our Radiology patients (using C/S ITS) have procedures that are not being checked for MN.
Has anyone else run into this problem and what did you do to address it? Meditech suggested two things, neither of which we will use: either flip the insurances when the patient is registered (making Medicare primary and their other insurance secondary) and then flip them back after the procedure is ordered or change the financial class for the primary insurance (which would cause a whole host of statistical problems). Right now, we are going to try to manually "catch" these patients that have Medicare as secondary insurance, hoping that between the depts and Admissions, we get all of them. Any ideas/help would greatly be appreciated! tia, deb Deb Baltikauski Clinical Analyst Mendota Community Hospital 1315 Memorial Drive Mendota, IL 61342 815-539-1641 <mail to:[EMAIL PROTECTED]> CONFIDENTIALITY NOTICE: This e-mail and any attachments may contain confidential and privileged information for the use of the designated recipients named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please notifiy Mendota Community Hospital immediately by telephone at (815)539-7461 and destroy all copies of this communication and any attachments. =*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*= To subscribe or unsubscribe to the meditech-l, visit MTUsers.COM. To check the status of the meditech-l, visit MTUsers.NET. For help, email [EMAIL PROTECTED] ______________________________________ meditech-l mailing list [email protected] http://mtusers.com/mailman/listinfo/meditech-l
