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.
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 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.
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.
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.
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.
Easily identify HMO and Medicare Advantage data
Stop wasting valuable time and money submitting claims that a patient’s insurance won’t cover. Now you can know from the start exactly whom you can bill.
Re-verify HMO, PPS episode and Advantage Plan data
Our monthly re-verification process performs a full update for all patients, allowing you to see any changes in HMO, PPS episode and Advantage Plan data. By comparing current coverage to what was last on file, you can quickly identify coverage changes.
Decrease registration errors
Our eligibility verification makes it simple to confirm the information received at your reception desk matches that found in the Medicare system.
Reduced denied and rejected claims
See the top reasons for denied and rejected claims. Take specific action to reduce denials and rejections, ensuring that more claims are processed the first time.
Increased staff efficiency and cash flow
Greater insight into your data helps you fine tune your revenue cycle. Reduced A/R days means more money in the bank!
Advanced management reporting and analysis
Get detailed information on your claim outcomes and follow-up process. Better information lets you target specific areas for improvement.
Simplified Medicare claim editing
With a single click, easily make changes directly to your claims. Edit the exact line item in question and never again delete and re-key entire lines. Immediately submit edited claims or save them to submit later – you choose what works best.
Keep track of your work
You can swap primary and secondary payers in just one click, instead of retyping all the data in the FISS system.
