Integrating Code Auditing Solutions

McKesson's integration modules can be used for several industry-standard claims processing systems. Full McKesson auditing functionality, including some payor-defined customization, can be readily created and applied, without additional IT resources.

Increasing Efficiency through Integration

With the McKesson interface, claims data are automatically passed between payors' processing systems and the McKesson auditing application. Moreover, the interface pulls data such as physician network status and claim classifications indicators into the McKesson application.

This integration allows payors to:

• Eliminate time-consuming manual entry of claims data and auditing results
• Gain more control to filter claims against business criteria
• Increase productivity and auto-adjudication rates
• Apply auditing to historical claims data
• Take advantage of other code auditing modules, such as ClaimReview™ and ProMatch™, which help further reduce manual claims reviews

Talking Technical

McKesson's interface offers dynamic data formatting, cross-walking, filtering, unit expansion and result mapping. Because payors' systems each present unique system configurations and workflows, McKesson's technical team works with payors' IT staffs to design the optimal integration solution.