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MedCom specializes in OR Charge Optimization and
835 Payment & Denial Trending Analytics in addition to a variety of CDM Management and Charge Capture Services.
Not sure where to start?
Scroll down to see our recommended and customizable Three-Phased Approach.
MedCom's three-phased approach
Pricing and Charge Capture Audit
- Fee Schedule Audit identifies reimbursement shortfalls based on negotiated payment rates.
- Market Position Analysis yields a perspective of how your facility charges compare to peers within the market
- Payment Assessment highlights possible underpayments and missed reimbursement.
- Charge Capture Audit detects missing charges and uncovers errors that impact revenue.
CDM Proactive Report Review
- Proactive Reports allow for an automated review of the CDM to diagnose major charge errors across all departments using MedCom’s proprietary software, C3NavigatorTM
- Report Validation confirms errors found for CPT/HCPCS Code, revenue code assignment, modifiers, and generates recommendations for correction
- Explode Structure Analysis ensures accurate charge structure and capture
835 Payment Audit
- 835 Electronic Remittance Advice Data Analysis highlights payment trends across time periods and by payors and identifies opportunities for improvements that result in complete payment.
Order Entry System Mapping Review
- Order Entry Review illustrates the linking of data between various clinical charge systems and financial chargemaster data to identify missing and erroneous mapping
- Exception Reports list items not mapped or identifies inactive charge codes
Charge Capture Review
- Charge Capture Review facilitates a “deep dive” into charge processes across systems to produce change recommendations for improved revenues and compliance
- Departmental Interviews provide an in-depth understanding of current practices and lead to error correction and sustained improvements through staff education
I have worked with MedCom Solutions on several occasions, and have found their work to be excellent. Their consultants are knowledgeable and thorough. They are also good listeners who pay attention to the client's needs, and then pay attention to all the details.
Hospitals are better at collecting data than analyzing it. MedCom has proven their value in their ability to analyze intrinsic surgery data to provide a strategy for restructuring the operating room theater to gain total reimbursement.
I have worked with MedCom Solutions for many years at multiple hospitals. MedCom's in-depth clinical and system knowledge has provided valuable insight through expert analytics uncovering notable root problems with substantial reimbursement gains.
I have worked with MedCom at two hospitals now and the level of knowledge and professionalism of everyone is truly exceptional. They are quick to respond to requests for information with accuracy and confidence. Their recommendations have resulted in additional reimbursement while insuring compliance.