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Claim Adjudication, Compliance, and Reimbursement |
| Achieve a consistent and reliable claims review process with claim adjudication, compliance, and reimbursement products from Ingenix. |
- Reduce the time to review claims
- Accurately and efficiently review claims
- Decrease administrative expenses
- Comply with HIPAA requirements
- Achieve consistency in claims processing
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Products:
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APC Assistant™
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APC Assistant™ is a comprehensive, web-based resource that contains all the latest regulatory information so you can keep pace with the nuances and changes inherent in the APC methodology. |
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CPT® Coding Resources
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Our line of CPT® code books provide a one-stop lookup of the official CPT® code set, rules, and guidelines. Claims and benefits administrators can reference these books to make educated decisions while reviewing claims. |
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Cross Coders
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Easily identify the correct relationship between the CPT® code and the complete listing of ICD-9-CM and HCPCS Level II codes to assist you in claim adjudication for various specialties. |
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Data Files
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Subscribe to receive the most accurate, up-to-date code data for your hospital’s coding needs. These tools will help your hospital or clinic to simplify update processes and improve coding accuracy.
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Desk Reference Suite
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The Coders’ Desk Reference suite provides claims administrators with a comprehensive guide to a wide variety of commonly-asked questions regarding ICD-9-CM, CPT®, and HCPCS Level II codes. |
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ECMPro™
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ECMPro™ is an embeddable software library for claims adjudication, analysis and managing risk. Its groupers, pricers, editors and other PPS tools seamlessly integrate with claims processing systems. |
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Education and Training Resources
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Rely on Education and Training resources from Ingenix to keep you current on how to implement code changes, apply government regulations, and feel confident your coding is compliant.
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HCPCS Level II Coding Resources
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Use the HCPCS Level II Professional and Expert code books to properly document the supplies, services, and drugs your facility uses. Includes symbols, color coding, and expert advice to help you find the right code quickly. |
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ICD-9-CM Coding Resources
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This unique ICD-9-CM code book contains exclusive components for managing claims payment and providing critical coding edits and rules for physicians, hospitals, long-term care, home health and hospices. |
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Ingenix All-Payer Severity-Adjusted DRGs®
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The Ingenix All-Payer Severity-Adjusted DRGs (APS-DRGs®) is a severity-adjustment solution that analyzes administrative data to classify patients into meaningful clusters based upon the diagnoses and conditions of the patients. |
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Medicare Resources
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Discover ways to improve third-party collections, reduce billing backlog and avoid inaccurate code selection that can lead to audit with Medicare Resources from Ingenix.
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National Medicare Provider Rate File (NMPRF)
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The NMPRF is a national database of payment rates for inpatient and outpatient PPS for all Medicare participating hospitals. It contains everything you need to calculate payment for any Medicare facility. |
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Online Coding and Referential Resources
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Integrating our robust online coding, billing, and reimbursement solutions can help you efficiently reduce costs, optimize labor, and improve process management.
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Web.Strat™
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Web.Strat™ is a browser-based application that delivers the necessary tools for payers to efficiently reimburse providers using PPS, and offers a wealth of resources via Ingenix’s PPS knowledge-base, methodologies and tools. |
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