Solutions by Client Profile

• Provider Solutions

  From multi-state hospital facilities to solo physicians, from laboratory systems to medical device manufacturers, we provide comprehensive support to medical providers, suppliers, and practitioners. Visit the Provider Solutions page for an overview of medical necessity, coding, claim scrubbing, Medicare secondary payer, excluded party notification, consulting, and data solutions designed for you.



• Payer Solutions

  We assist payers in managing their data needs, including insurance companies, claims processing entities, and review organizations. Visit Payer Solutions for information on how we can help you with claim scrubbing, medical necessity verification systems, data files, coding tools, and consulting services.



• Third Party Vendor Solutions

  We are a national leader in providing data files to software vendors, web service providers, clearinghouses, and third-party integrators. To find out how we can package medical necessity, coding, claim scrubbing and other data into a cost-effective solution that allows you to concentrate on your core business, visit Third Party Vendor Solutions.
  

  Solution Areas		Providers	Payers	Vendors
  Medical Necessity	Medical necessity management for Medicare and commercial payers. Server, thin-client, and web-based provider solutions. Data files for CPSI, Epic Systems, Fletcher-Flora (FFlex eSuite, LabPak), MediTech & other systems. Data services for vendors.
  Data Files	Coding and reimbursement data for use in third-party software systems, databases, claims processing systems, and web services. Medical necessity, code sets for hospitals, physicians, labs, DME, CCI, fee schedule data, DRG, MDC, zip code verification, more.
  Claim Scrubbing	Comprehensive claim scrubbing systems, from single module to full claim editing. HIPAA-compliant transactions and code sets. Server, appliance, ASP, and web-based options. Flexible packages to meet the needs of organizations of all sizes.
  Coding	Coding and reference software, coding engines for software vendors and service providers. Packaged and customized software, ASP, and web services.
  Excluded Party Verification	Immediately verify that providers, employees, and vendors are not in Medicare's Excluded Party database. Allows individual instant checks as well as automated batch checks. Web-based application, optional server/PC software.
  Medicare Secondary Payer	Easily determine and document Medicare Secondary Payer status. Print and save results to satisfy your MSP obligations. Web, server, thin-client, and PC platforms.