This past week, Access Innovations hosted the annual Data Harmony Users Group (DHUG) meeting, which has included a variety of presentations. We presented a case study titled “Proven Technology in a New Market: the Data Harmony Suite of Products — A Game Changer in the Medical Claims Compliance Space.” Here’s a quick summary:
In 2014, the following challenges (which healthcare information professionals in the United States will recognize as major new regulatory requirements) will face all medical providers and payers:
• Meaningful Use Stage 2 requirements
• Revised form 1500 from Center for Medicare/Medicaid Services (CMS)
• 2014 changes to Current Procedure Technology (CPT)
• Billing changes for Non-Physician Practitioner (NPP)
• New edits for Correct Coding Initiatives (CCI)
The approaching tsunami in the medical compliance industry has resulted in a perfect fit for Data Harmony’s semantically enriched, rule-based concept extractor software solution. Our first order of business was to investigate at what point in the medical transaction process Data Harmony’s suite of time-tested software products would be the best fit and what would be the most cost-effective results. Research indicated that our technology would be a game changer in the following areas:
- Reduce the risk of compliance audit
- Expedite claim submission
- Accelerate cash flow… fewer denials and rejections
- Improve coder productivity
- Allow real-time analysis of electronic medical records (EMRs)
The technology transferred from electronic publishing to medical claims compliance has instituted a disruptive innovation within a new industry. The rule-based approach provides very high accuracy and consistent, productive, efficient, and cost-effective EMR analysis throughout the medical billing and transaction sphere.
About the authors/presenters:
John Kuranz brings more than 30 years of experience in electronic publishing and internet applications in research and content creation to the Access Integrity team. Most recently, Kuranz spent three years as managing director of Dallas, Texas-based Chemical Information Services, a B2B subscription-based chemical database firm. Prior to joining Access Integrity, Kuranz was executive vice president of global business strategy at Herndon, Va.-based Apex CoVantage, an outsourcing company with more than 3,500 employees worldwide. In this role, Kuranz was instrumental in positioning the company as a leader in providing knowledge-based solutions to the information and publishing industry. Kuranz has a bachelor’s of science degree in biochemistry from Texas A&M University and did his MBA studies at Northern Illinois University. Kuranz and his wife, Karen, reside in Santa Fe, N.M.
Kathryn (Kathy) Brown is an editor and taxonomist with Access Innovations. In addition to taxonomy and thesaurus creation and maintenance, her job responsibilities include indexing, rule building, and creating and maintaining databases. She has diplomas in nursing and in paralegal studies. A former nurse and paralegal, Kathy brings her medical and legal knowledge to healthcare-related and legal projects. Her outside interests include poker and mandolin playing.