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Medical Billing Service Solutions

 

MDeverywhere has put together a unique integrated solution that includes web-based practice management software, expert systems, and best-in-class medical billing services. Our comprehensive medical billing services include claim submission, electronic eligibility verification, payment posting, claim follow-up, denial management, insurance rule creation, insurance contract definition, appointment reminder calls, patient recalls and more – all executed on your behalf by MDeverywhere.

Increase Your Practice Revenue

  • Reduces Insurance Denials: MDeverywhere’s Palm and web-based charge capture software includes a rules engine with 15 million payor specific rules. These rules eliminate coding and demographic errors at the point of care. In addition to eliminating denials, our knowledge base increases revenue by finding missing CPT codes. MDeverywhere’s denial team builds additional rules based on your specific denial trends – the system gets smarter.

  • Enforces Payor Contracts: On average, commercial insurance carriers underpay claims by 7%. With our payor contract compliance service and client specific payor knowledge base we are able to identify and appeal all underpaid claims.

    • Contract definition and modeling: An MDeverywhere contract analyst reviews the practice’s payor contracts and builds a knowledge base that is practice specific. This knowledge base includes the contracted payments and all payment rules including service carve-outs, global fee periods, multiple surgery reductions, modifier multiples, code edits, site-of-service payment adjustments and private payment rules.

    • Continuous updates on contract terms, fee schedules and reimbursement rules: To ensure claims pricing is accurate, the MDeverywhere team monitors your contracts and continually updates your practice specific knowledge base with any new contract terms, fee schedules and reimbursement rules.

    • Identification of underpayments: The MDeverywhere system uses your practice-specific knowledge base to compare payments received against the contract terms and flags underpayments at the line-item level.

    • Contract-based appeals: MDeverywhere appeals every underpayment that is identified and provides the carrier with the contract-based explanation needed to successfully process the appeal.

    • Follow-up appealed claims: MDeverywhere follows up on every appealed claim and makes sure the payors are paying what they are contractually obligated to pay.

    • Reporting and analysis tools: Using the data stored in our system we can create custom reports for monitoring overall payor performance and negotiating improved contract terms.

Retain Control

MDeverywhere clients retain complete control of their practice. Using the MDeverywhere web-based medical billing software you can electronically access schedules, patient ledgers, financial reports, payment and denial batch statuses, EOB images and you can communicate with your MDeverywhere Account Manager to resolve claim exceptions.

MDeverywhere is confident your revenue will increase by using our knowledge-driven systems and best-in-class services. We also make it easy for you to become a client. With MDeverywhere, there is no contract, upfront software license fees or fees for training and implementation. You simply sign a one page fee agreement that can be cancelled at any time. We get paid a percentage of collection.

For more information about our products and services, click here to contact us or
call us toll-free at 866-340-5500

   

What our clients say...

“Prior to implementing ClaimsManager, approximately 11% of claims were being denied. With ClaimsManager, the number of denials is under 1% per month. ClaimsManager has helped identify the triggers needed to reduce the rework, transition work to the front end and improve communication and education back to the physicians. ClaimsManager helped us manage our denials and the combination of ClaimsManager and MDeverywhere’s EveryCharge has resulted in improved staff efficiencies, reduction in A/R days, and improved revenues to the organization.”

Debbie Rivers, Manager of Financial Services
Carle Clinic Association

 
 

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