Medata Software - What's Next In Bill Review

Enterprise Level Performance

Medata, the originator of Automated Medical Bill Review has processed over 400 Million procedures over the last 33 years - that is well over 150 million bills in just 10 years.

Service Options

Our Clients can chose to host the software on their own workstations, servers or via the internet. Medata can host the software on its secure ASP environment. Medata's bill review engine CORE, can review over 8,000 bills per hour without human intervention. Medata Services offers an outsource option that allows clients to mail paper bills directly to service centers for scanning and OCR.

Call For Demo

Call 1-800-854-7591 or email sales@medata.com .

CORE

The CORE engine is the backbone of the Medata bill review application. The engine processes bills according to the specific jurisdiction applicable fee schedule or UCR value, PPO Network contract rate, prevailing billing guidelines and client defined business rules without any human intervention, making it a truly automated process. Our business rules engine featured within CORE allows users to create client specific rule sets that are stored and applied to all bills further enhancing the automation review process. What sets this rules engine apart from others in the industry is its ease of use. This was designed with the user in mind. Each of the elements necessary to perform bill review is available as a building block for the user to choose from when creating a specific business rule.

Product Features

  • All Workers’ Compensation & Auto Liability
  • National and Regional PPO Networks
  • Drugs & Supply Database
  • Supports state medical bill data reporting
  • State Mandated EDI Reporting
  • Custom reporting tools
  • Integrated Utilization Review Management
  • Dedicated Customer Service Department
  • National and Regional PPO Networks
  • Flexible database access
  • Detailed, state-specific explanation of reviews (EOR)
  • Duplicate billing detection
  • Multiple automated quality assurance checks
  • Over 100 Clinical edits including: Global surgical package, Starred procedures, Unbundled services, Assistant surgeon
  • Bill notes — data entry note fields that are designed to hold pertinent data specific to that field

Project Management

Included in the software installation process, Medata, Inc. offers a Statement of Work, which is a thorough review of implementation parameters designed to manage our client’s expectations and ensure a seamless transition. Each step of the way, our IT staff and Project Managers work to make certain that the history conversion, electronic data interfaces, and EOR exports are accurate. Claim, Provider and Employer files are loaded upfront to guarantee precise data output.