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Medicare Enterprise

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Everything you need to improve your revenue cycle management.

The Medicare Enterprise package is the most efficient revenue cycle management solution on the market. From checking eligibility verification to evaluating claim data and even working claims in RTP, this package provides your organization with all the necessary tools to work Medicare claims online. This is a serious end-to-end solution that takes your claims through the entire reimbursement process.

Medicare Reporting and Analytics

Comprehensive claims reporting and analysis makes it simple for you to spot and trend any negative outcomes currently plaguing your billing and follow-up process. The Medicare Enterprise package provides you with hassle-free claims analysis and gives you complete access to all of your claim data. You even receive invaluable analysis and trending reports to assist you in making essential changes to your billing process.  Use this data to make informed decisions that will reduce denied and rejected claims while increasing your cash flow and staff efficiency. 

Medicare Claims Correction

Medicare Enterprise allows Part A providers to correct and update claims directly in the Medicare system using our browser-based, UB-04 environment. Our tool dramatically increases staff efficiency by allowing a higher volume of claims to be corrected in a shorter amount of time. You'll have the easily accessible information you need to work paid, rejected and RTP claims. You can even submit Notices of Election and roster bills, and you'll also have a detailed audit trail for compliance. Claims correction is available 24/7 so you’re able to work when it best suits your needs. Need to automate your DDE claim submission? We can do that, too.

Medicare Eligibility Verification

The Medicare Enterprise solution retrieves data directly from the Medicare system so we can provide you with a more comprehensive eligibility report than the traditional EDI based system. Because of our ability to access this unique data set, we're also able to correct data discrepancies such as misspelled names, incorrect HIC numbers and DOB.

Connecting to the Medicare DDE

Connection tools that require you to invest in additional phone lines, hardware or software are a relic of the past. With Medicare Enterprise, you get everything you need in a web-based tool that works on your existing equipment. Unlike other connection methods, Medicare Enterprise actually allows you to connect to multiple MAC regions simultaneously.

Claims Submission

Medicare Enterprise gives you a complete snapshot of activity on your 835/837 file transmissions. You can quickly review which of your claims have been accepted, rejected and processed. This allows you to easily prioritize and troubleshoot your workload.

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