The Functionality You Need
Our clearinghouse transaction module manages all types of input and output between all types of healthcare organizations. This is our fully integrated solution using real-time, near real-time, batch, fast batch, or any other speed of file synchronization available.
Charge Entry and Billing Module
We process all claims in an electronic format, whether received electronically or a paper charge sheet from a lock box, scanning process, or other paper source and converted by OCR technology to a digital transaction. Because we treat everything as a digital transaction, all transactions are processed through the business rule engine to automate traditional billing steps such as coding, pricing, payor specific rules, and critical field validation, and then are transformed to a HIPAA-compliant claim format and extracted electronically to carriers for payment.
The Denial Manager Module identifies and accounts for all payor denials to target problem areas that affect the bottom line to assure collection of all receivables due from payors. Our Denial Manager Module also allows providers to organize and manage remittance inventory; helps staff arrange, prioritize and monitor denials and underpayments; and allows the accurate reporting and viewing of the denied and adjusted amounts.
Our Collection Module is a rule-based workflow engine with configurable work queues and the ability to prioritize work based on aging, uncollected claims by client. The module processes claim status messages for the most accurate disposition and pinpoints the bottle neck in the revenue cycle payment process. Unclean claims that are not paid after being processed by the payor are sent to an exception queue to be reviewed, fixed, and re-submitted.
Posting and Reconciliation
Electronic transactions (or paper EOBs received via lock box service, scanning process, or other paper source) are converted by OCR technology to a digital transaction. Once it’s a digital transaction, all transactions are processed through the business rule engine to automate posting payment, adjustments, and reconciliation at the check level, claim level, and service line, balanced to check deposit, transformed to a HIPAA compliant remittance format, and extracted electronically to the client.
For pennies per page MDiQ lets you treat paper documents just like digital transactions. We convert data, index fields, store documents for viewing, and route paper documents for editing with seamless ease. We can take in paper and give you an all-digital feed, and we can take an all-digital feed to produce the paper documents that you are currently sending.
Reporting and Analytics
With the proper visibility, payors and providers can gain valuable insight into their revenue cycle processes. With MDiQ’s Healthcare Business Analytics, specialized reports delivered in real-time, anytime, give you the chance to make informed decisions about claims and correspondence. Identify and remedy exceptions, manage revenue, member and provider information, as well as government-required reporting in one interface.