Healthcare Imaging & IT - July 2008 - (Page 37)

CAPTUS 3000 ® Count on Capintec with the Thyroid Uptake and Well System “CMS has acknowledged that medical necessity reviews sometimes involve gray areas of Medicare policy.” Andrew B. Wachler, healthcare attorney, Wachler & Associates, Royal Oak, Mich. Captus ® 3000 The Captus® 3000 comes Displaying the equipped with a “Quick Start Quick Up” feature that walks the “Pull quote Cras dictum, arcuStart-Up quis Screen user through all program egestas tincidunt, setup functions. The feature nisl pede rutrum will have you varius metus dolor et nisl, non performing patient studies in no time! It massa. a trainalso serves as Pull quote Cras dictum, non ing tool for additional varius dolor et massa.” users, while proName, Title, Facility viding fast, dedicated modules for Thyroid Uptake, Wipe Tests, Schilling Test, Blood Volume, RBC Survival and Bio-Assay. The RAC in California did not comply with Medicare policy governing the determination of medical necessity for inpatient care, she says. “For example, they used InterQual Criteria [by McKesson] to make determinations regarding short inpatient stays vs. observation, which is not compliant with Medicare policy,” Blaisdell noted. “In addition, they did not use appropriately qualified personnel for the reviews of patients admitted for inpatient rehabilitation services and made thousands of inaccurate determinations, as evidenced by the results of the validation review and the high turnover rate of appeals.” According to Wachler, CMS “paused” PRG Schultz’s authority to review these claims and commissioned a different and independent contractor to review a sampling of claims previously reviewed by the RAC. “That contractor disagreed with approximately 40 percent of the determinations made by PRG Schultz.” In response to outcries from California healthcare providers, Representative Lois Capps (D-Calif.) of Santa Barbara introduced legislation (HR 4105, currently in committee) last November with 96 co-sponsors, seeking to place a one-year moratorium on all RAC activities. “As increasing numbers of [recovery audit contractors’] denials are overturned on appeal in favor of the healthcare providers, we are finding a program that is wasting perhaps as much taxpayer money as it is purportedly saving,” Capps stated. “Even worse, this whole process of denying payment for legitimately provided services is placing an enormous financial burden on healthcare providers that jeopardizes their ability to care for their patients.” As a result of the mistakes that occurred in the California demonstration project, Wachler noted that CMS will require RACs to seek CMS approval before beginning medical necessity reviews of provider claims. “CMS has acknowledged that medical necessity reviews sometimes involve gray areas of Medicare policy,” he said. “The CMS oversight is intended to ensure that providers are not unduly burdened or second-guessed by the RACs.” According to W. Kenneth Davis, Jr., partner in the Chicago-based Katten Muchin Rosenman law firm, all healthcare providers regardless of their area of specialization, are subject to RAC scrutiny. “There really is no ‘RAC defense’ per se,” he says. “The best thing to do is what physicians and suppliers have been told to do for a long time: code and bill accurately, don’t perform procedures that are of questionable medical necessity, and certainly never bill for a procedure that you didn’t perform.” HealthImaging.com Cap-DICOM Software ® Capintec is proud to announce a new software application for its Captus ® 3000 Thyroid Uptake System designed to help meet the needs of our customers working in a digital reporting environment Cap-DICOM™ adds DICOM modality worklist and DICOM export to the Captus® 3000. This solution allows patient information and demographics to be pulled from the Radiology Information System (RIS) or Hospital Information System (HIS), thus, reducing errors and time associated with the manual input of patient information. Cap-DICOM™ creates a DICOM secondary capture image from information generated during the uptake procedure. The software exports the DICOM image files to a destination DICOM C-Store provider specified by the user. This destination may be a nuclear medicine workstation or PACS. To learn more about the Captus ® 3000 Thyroid Uptake System, Cap-DICOM ™ Software and many other great Capintec products, contact a Capintec representative at 201-825-9500 or toll free at 800-631-3826. Capintec, Inc. 201.825.9500• 800.631.3826 www.capintec.com July 2008 | Health Imaging & IT 37 http://www.capintec.com http://HealthImaging.com

Table of Contents Feed for the Digital Edition of Healthcare Imaging & IT - July 2008

Healthcare Imaging & IT - July 2008 On the Web The Enterprise News Update Convention Spotlight: AHRA 2008 Cover Story: Driving Metrics to Drive Business: Digital Dashboards Deliver Mammography CAD Comes of Age Breast MR CAD: Earlier Detection, Increased Efficiency Lung CAD Earning a Spot in Day-to-Day Practice Colon CAD: Breaking Down Barriers Modality Review: Cardiac CT Angiography: A Clear Pathway to Better Cardiac Patient Management Practice Management: RIS Rights Efficiency & Productivity Wrongs In Practice: Advanced Visualization Across the Enterprise Regulatory Update: Beware: Recovery Audit Contractors Poised for Permanent Status Technology Outlook: Compressing Images for Remote Transmission Reader's Resource Stat Sheet

Healthcare Imaging & IT - July 2008

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.