Software system screens for compliance problems
Software system screens for compliance problems
Atlanta-based Medaphis Corporation has designed a unique new software system to edit physician claims for possible compliance problems before they are submitted for payment.
The system, called ComplyCare, is based on a database of more than 60 million claims powered by IBM's Fraud and Abuse Management System. According to company officials, the system is capable of comparing 100% of a physician group's claims with claims in the firm's database.
"We provide our clients with a CD containing information and reports that can help physician groups look at their practice similar to how private payers and the government do to spot questionable billing and behavior patterns," says Terry Peltes, vice president for physician management services at Medaphis.
Groups signing onto the service are eligible for a billing errors insurance program available through the Graham Company in Philadelphia.
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