CompliantRx eases ‘document crunch’

CORAL SPRINGS, Fla. – They say necessity is the mother of invention and that’s certainly true for Adam Nadler, co-founder and CEO of both Quest Health Solutions, a provider of diabetes products, and his newest venture, CompliantRx.  

CompliantRx is an AI/ML-powered platform that automates medical record review for HME providers by identifying the necessary coverage criteria and highlighting any missing information, providing feedback within minutes. 

“We’ve been operating in the DME space for several years and one of our major pain points was medical record review,” said Nadler. “As we were growing and we looked to remain compliant, we realized how antiquated the review process was – here’s a checklist on paper for the Medicare requirements. There was no existing way to use automation.” 

While CompliantRx is already in use by ACU-Serve and GEMCO Medical and is being beta tested by others, it made its official debut at Medtrade in March, where it secured a spot on the Tech Stage. 

Nights and weekends 

As one of 15 direct distributors of the FreeStyle Libre CGM, Quest Health lives in a fast-paced environment of onboarding patients and, subsequently, of meeting Medicare’s continued use criteria every six months, Nadler says. 

“We could see very early on how the DME industry could benefit from something like automated medical review, because it was a document crunch for us,” he said. “I spent two years, nights and weekends, tagging medical records, training the algorithms for CGMs and highlighting key words like insulin. We have medical record annotators now, but I used to do it all. That’s how our AI knows what to look for – it has been trained with extreme precision.” 

The result: It now takes Quest Health seven minutes – instead of up to 30 minutes – to review documentation, Nadler says. 

Big proponent 

Nadler built out a specific workflow for CPAP products for ACU-Serve, training the CompliantRx platform on more than two-dozen new tags like AHI and neck circumference, he says. 

“Now, with a click of a button, if they have to interpret an AHI number, it takes you to where the score is,” he said. “There’s still that human element – if you’re above a certain number but below a certain, you qualify – but it reduces the time it takes." 

The result: ACU-Serve has knocked 10 minutes off the process, making the company “a big proponent” of the platform, Nadler says. 

Time is money 

In an industry where time is increasingly money, CompliantRx, which is integrated with Brightree, can make a significant difference, not only for diabetes and CPAP products but also walkers, canes, crutches – you name it, Nadler says.  

“We’re looking to partner with DMEs who see a need for efficiency and who want to protect themselves from denials and audits,” he said.