Clinical Decision Support Mechanism (CDSM) Solution

Ensure imaging procedures
you perform will get reimbursed
by Medicare.

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Infinx CDSM Solution

If you already use our artificial intelligence driven Prior Authorization Software, you are familiar with how easy it is to obtain timely preauthorizations from commercial payers. Our new CDSM solution can now help ensure you obtain certified compliance certificates for advanced imaging orders covered by Medicare.

Currently, we are the only CMS-approved solution on the market that has developed a comprehensive CDSM solution that can be integrated with a Prior Authorization Software.

New CDSM Mandate

Starting January 1, 2020, physicians ordering specific advanced imaging tests for Medicare patients must confirm their treatment decision by consulting appropriate use criteria (“AUC”) with a Center for Medicare Services (“CMS”) approved electronic clinical decision support tool (“CDSM”) pursuant to the Protecting Access to Medicare Act (“PAMA”) passed in July 2014.

Proof of such consult must then be provided to the rendering physician who submits it to Medicare along with the claim for reimbursement after the imaging test is performed. In 2021, reimbursements will be withheld if it is determined that the ordering physician did not consult a CDSM tool before ordering the procedure.

New CDSM Mandate

How We Do It

Infinx CDSM Workflow
Prior Authorization Calculator

Prior Authorization Calculator

Use our simple calculator to determine how much you can save with our Prior Authorization Software.

Infinx CDSM Solution Key Features:

Approved CDSM Tool

Our CDSM Solution received CMS-approval as of December 20, 2019. We ensure full compliance to the CMS requirements of consultation and reporting, including prior authorizations.

High-Quality Clinical Decision
Support Experience

Provides ordering physicians with a high-quality clinical decision support experience with a rich library of AUCs sourced from Qualified Provider Lead Entities (QPLEs) like Sage Evidence-based Medicine & Practice Institute (SEMPI).

Recommendations For Appropriate Procedures

After accepting patient details, the software follows a simple flow and generates the “compliance certificate” that will ensure compliance.

Coverage Of All Priority Clinical Areas

Specialties include coronary artery disease (suspected or diagnosed), suspected pulmonary embolism, headache (traumatic and nontraumatic), hip pain, low back pain, shoulder pain (to include suspected rotator cuff injury), cancer of the lung (primary or metastatic, suspected or diagnosed).

Clinical Dashboard

Provides immediate access to current patient information for both furnishing and ordering physicians.

Extension of Infinx Prior
Authorization Software

Seamlessly connects with our artificial intelligence driven prior authorization solution to cover imaging orders by Medicare.

Benefits To Your Organization

Infinx CDSM Solution

One solution for managing CDSM requests for Medicare orders and prior authorizations for commercial payer orders.

Ability to Support All Referring Physicians

Ability to support all referring physicians without complex integration into their EMR systems.

Infinx CDSM Solution Consult

Identify all Medicare orders that will require a CDSM consult.

Reuqest A CDSM Consultation

Ability to request a CDSM consult even if it was missed at order creation.

Infinx CDSM - CMS Reporting

A single repository of all your CDSM request and consult certificates for CMS reporting.

Manage Your CDSM Referrals and Prior Authorizations with One Solution

Ensure your advanced imaging procedures are approved and paid by Medicare

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