Medicare Enterprise Pro

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Our most complete revenue cycle management solution.
Do everything with Pro!

Medicare Enterprise Pro is our most complete revenue cycle management solution. As an end-to-end solution, this package is the premiere choice for reducing denials and improving reimbursements. From checking eligibility verification to evaluating claim data and even working claims in RTP, this package provides your facility with all the necessary tools to work Medicare claims online. What sets Medicare Enterprise Pro apart is its quality and compliance tools. Regardless of your industry, we have the file submission and reporting tools (OASIS, MDS, HIS, CASPER) that will allow you to offer the best patient care possible.

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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. This package provides you with hassle-free claims analysis and gives you complete access to all of your claim data. You even receive invaluable trending and analysis data that helps you make essential changes to your billing process. Utilizing this data allows you to reduce your denied and rejected claims while increasing your cash flow and overall staff efficiency.  Needing to bill Medicare as a secondary payer? We've got you covered.

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Medicare Claims Correction

Medicare Enterprise Pro allows Part A providers to work claims through a web interface rather than working in the Medicare system. It dramatically increases staff efficiency by allowing a higher volume of claims to be corrected in a shorter amount of time. Not only can you correct claims in a familiar UB-04 environment, but you also receive full audit trail capabilities. This is essential for staying compliant. Claims correction is available 24/7 to make sure that you’re able to work when it best suits your needs. Need to automate your DDE claim submission? We can do that, too.

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Medicare Eligibility Verification

The Medicare Enterprise Pro solution checks patient eligibility in real time or through a batch process. It offers you fast, efficient and integrated eligibility verification. Decreasing registration errors has a direct effect on increasing your staff efficiency and cash flow. The real time eligibility checks allow your staff to get immediate results, when they need them.

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Quality and Compliance Tools

Medicare Enterprise Pro offers you a secure and reliable way to transfer all of your required quality and compliance files. Whether it’s OASIS, MDS, HIS or PBJ, you get a complete snapshot of your file activity and can quickly identify what’s been accepted, rejected, and processed. All of this information can then later be reviewed through a final validation report. The export and filter features let you save and display all your file data in multiple formats. The filter and layout features let you customize your work environment and save it for future use.

Home Health providers: Take advantage of our OASIS analysis capabilities. Medicare Enterprise Pro performs a complete analysis of your files assessment, flags potential issues, and even returns recommendations.

Not reviewing your CASPER reports as often as you should? Let us automatically deliver them to you as often as you’d like. This gives you more time to review and analyze your CASPER reports to prepare for your survey. What’s more, with monthly reports, you’ll be able to quickly identify problem areas and take steps to correct them to improve your scores. It could very well be the factor that pushes a potential customer in one direction or the other.

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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 Pro, you get everything you need in a web-based tool that works on your existing equipment. Unlike other connection methods, Medicare Enterprise Pro actually allows you to connect to multiple MAC regions simultaneously.

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Claims Submission

Medicare Enterprise Pro 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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