We all know that transitioning to the new coding system will comeimage at some point in time and the date for compliance has been pushed back a year as there’s just so much on the plate of hospital CIOs today that priorities needed to be established to allow the processes to build and take place.  Just yesterday I made this post about HHS and DOJ stating they had sent letters out to several healthcare organizations about “gaming” the billing system with Medicare. 

The next day another article came out and said the government share in the blame here too…well gosh someone realized that the old witch hunt days are gone when it comes to technology.  imageThe company Nuance is purchasing is one of “those” companies that help with better coding and revenue cycling, so cased closed on that one as I stated in my post, with consultants and software, hospitals and others are on the whole getting smarter about revenue that may have been left on the table in the past and sure costs go up when additional dollars are recovered.  At any rate the government side may want to look at the number of 3rd party HIT companies out there and see if maybe this is the case with smarter billings as that’s what everyone wanted and the additional costs may just be the result of some of this activity.  Just again one more reason why executives figureheads need some IT experience in their background as it could have saved this somewhat embarrassing situation with not having all the facts together to see why and shooting out blanks about “gaming” the billing system. 

HHS and DOJ Send Letters to Hospital Trade Associations Warning of Gaming Billing System Via Use of Electronic Medical Records–Hospitals Just Learned How to Bill Better & Hired Consultants–Case of Being Algo Duped With Numbers?

Of course there are the absolute blatant abusers and that’s a different story as those folks should be investigated and prosecuted as needed.   For the most part though most are just recovering additional funds they didn’t used to bill for now that documentation for the higher dollar codes is available and easier to use with medical records.  Here’s a list of the QuadraMed Quantim product from the website. 

Quantim Products:

Quantim® Coding
Quantim® Compliance
Quantim® Computer-Assisted Coding
Quantim® Abstracting
Quantim® Clinical Documentation Integrity
Quantim® Record Management
Quantim® Electronic Document Management
Quantim® Workflow
Quantim® File Manager
Quantim Service Utilization and Optimization Review

Press Release:
BURLINGTON, Mass., – September 27, 2012
Nuance Communications, Inc. (NASDAQ: NUAN) announced today that it has signed a definitive agreement to acquire Quantim®, the Health Information Management (HIM) business of QuadraMed, a provider of leading information technology solutions for the healthcare industry. Working closely with industry partners, including electronic healthcare record (EHR) providers, Nuance and Quantim will ease healthcare providers’ transition to ICD-10, while preserving clinician productivity and document workflows and, most importantly, ensuring the quality of patient care.

Quantim provides hospitals and healthcare organizations with software and services that maximize HIM professionals’ productivity while ensuring appropriate financial imagereimbursement to the institution. With the government-mandated transition from ICD-9 to ICD-10 codes, healthcare providers face unprecedented complexity in their clinical documentation and coding strategies. ICD codes, which serve as the foundation for financial reimbursement, are set to increase from 17,000 diagnostic and procedural codes today to more than 155,000 codes over the next two years. Every healthcare provider in the U.S. is affected by this change, and Nuance, together with Quantim, will assist customers through this critical transition and through future clinical documentation and coding challenges.

The integration of Nuance’s clinical language understanding (CLU) technology with Quantim’s computer-assisted coding (CAC) solution will fuel a more efficient coding workflow and speed related reimbursement. An automated, integrated coding solution will support clinician productivity during the transition to ICD-10 for providers and preserve document workflows and the quality of care.

“Nuance has a track record of delivering imagedisruptive innovations in healthcare, particularly when it comes to helping providers overcome major challenges like ICD-10,” said Janet Dillione, executive vice president and general manager, Nuance Healthcare. “We are excited to welcome the Quantim customers and staff to the Nuance team, and look forward to working together to create an innovative solution to help providers address critical productivity and reimbursement challenges associated with clinical documentation and coding.”

Nuance plans to deliver CLU-powered CAC solutions quickly into the market within Quantim's integrated, web-based platform to support a more efficient transition to ICD-10 and deliver better financial results for customers. These solutions will:

  • Bridge the capture of clinical information with natural language processing (NLP)-driven coding and compliance, ultimately shortening the time between patient care and appropriate reimbursement – driving to the industry goal of concurrent coding.
  • Streamline clinical documentation improvement (CDI) and support CDI and coding specialists within a single platform to decrease the time spent on physician follow-up when additional specific patient details are needed to properly code the care provided; and
  • Integrate Nuance’s CLU technology to aid coders directly by providing them with automated prompts that will assist them in ensuring compliance and adjusting to the increased ICD-10 code base.

“The acquisition of QuadraMed’s HIM business is a natural extension of Nuance’s strategy to transform the clinical documentation and revenue cycle processes,” said Duncan James, chief executive officer, QuadraMed. “We are enthusiastic about the opportunity this acquisition provides for our Quantim clients and employees who will benefit from the value of Nuance’s vision and innovative technology.”

For more information about this announcement and the benefits it will bring to healthcare provider organizations, please visit: http://www.nuance.com/for-healthcare/healthcare-announcement-quantim/index.htm

Nuance Healthcare

Nuance Healthcare, a division of Nuance Communications, is the market leader in providing clinical understanding solutions that accurately capture and transform the patient story into meaningful, actionable information.  Thousands of hospitals, providers and payers worldwide trust Nuance voice-enabled clinical documentation and analytics solutions to facilitate smarter, more efficient decisions across the healthcare enterprise.  For more information please visit http://www.nuance.com/for-healthcare/index.htm.

QuadraMed Corporation

QuadraMed, a Francisco Partners portfolio company, is a leading provider of award-winning healthcare technologies and services that improve the safety, quality and efficiency of patient care. Founded in 1993, QuadraMed provides proven, flexible solutions that help make our clients successful by streamlining processes, increasing productivity, improving patient satisfaction and driving positive clinical outcomes. For more information please visit http://www.quadramed.com.

About Nuance Communications, Inc

Nuance Communications, Inc. (NASDAQ: NUAN) is a leading provider of voice and language solutions for businesses and consumers around the world. Its technologies, applications and services make the user experience more compelling by transforming the way people interact with devices and systems. Every day, millions of users and thousands of businesses experience Nuance’s proven applications. For more information, please visit www.nuance.com.



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