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Bonex Data Systemss

Custom Software Development

Industry Experience >  Medical Industry

Medical Industry

Medical Necessity


Medical Necssity Problem: The hospitals do accidentally bill Medicare for non-covered charges, which can be considered fraud or abuse.

Solution: Bonex, Inc. developed an application, running the HCFA claims prior to submission. The program analyzes the patient information, confirms the proper medical necessity rules, and creates reports for claim correction and internal auditing.

Result: The rejected claims have been reduced from 10% to 2%.