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Kristy Manrique

Director Medical Necessity

Kristy Manrique joined Health Catalyst in September 2020 as Director of Medical Necessity. She is responsible for creating and maintaining medical necessity edits for Medicare, select Medicaid, and commercial payers. Manrique has over 25 years of experience in the healthcare field. Her background includes serving several years in health information management at an acute care facility as a certified coding specialist, CCS, CCS-P, where she led a team of hospital and professional coders. Manrique’s main responsibilities included performing coding quality reviews and providing education on new coding guidelines and regulation changes. 

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Commercial Medical Necessity Edits are Your Key to Fewer Denials

Healthcare organizations risk losing more than $200 billion annually to denied claims. Of this loss, medical necessity denials account for $2.5 billion. In response, providers need a mid-revenue management solution that includes healthcare claims management, such as medical necessity edits (MNEs), and ensures claims fall within acceptable standards. Accounting for MNEs for a broad range of commercial insurances in addition to Medicare and state Medicaid MNEs, the Vitalware® by Health Catalyst medical necessity tool offers a comprehensive, timely, and accurate solution to help organizations avoid lost compensation and revenue delays.

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