Revenue Cycle Management

What can MedHealthClaims do for my practice?


Accelerate Cash Flow


Reduce Denials


Prepare for ICD-10

From all-payer primary and secondary claims through full payment processing, our clients benefit from the most robust and easy to use tools in the industry. Some features our clients benefit from are:

  • All payer primary and secondary claims and ERA processing
  • No claim transaction fees to PAR payers (see payer list)
  • No transaction fee processing for ERA
  • Real time or batch patient eligibility
  • Industry leading data management/denial management and analysis
  • Payer, provider and user analysis tools
  • Medicare PQRI management and measurement tools
  • Superior organization wide reporting, drilled down to the provider level
  • Unlimited users with defined staff access to work areas
  • 1500 and 837 claim editors
  • Automatic 835 to 837 tie back for easy viewing
  • User level productivity monitoring tools
  • Automatic archival for 7 years of all transactions with simple search access
  • All HIPAA based transactions
  • EOB conversion tools to 835
  • One click access to every payer form you currently use, appeal forms, etc.
  • No set up, transition, training, enrollment, go live or support fees, period




MedHealthClaims Patient Eligibility

Increase profitability by decreasing denials

One of the most common reasons for claim rejection or denial is patients’ ineligibility. Rather than putting reimbursement at risk after a patient encounter, you can use MedHealthClaims as your front desk to verify the Eligibility in either real-time or batch to determine patient insurance eligibility prior to rendering service.

With MedHealthClaims you will be able to:

  • Avoid unnecessary rejections and denials – check eligibility before patients arrives
  • Increase daily profits –by reducing costly write-offs
  • Eliminates wastage of time – eliminate manual eligibility verification
  • Increase cash collections – obtain up-to-date co-pay, co-insurance and deductible information
  • Receive real-time access to critical patient and insurance information, including coverage dates, benefit ceilings, co-pays and more


Rejection Management

Get paid easier, faster and fully

MedHealthClaims comprehensive rejection management solution is designed to help you collect maximum money in minimum time with 100% effort. Our powerful team of rejection specialists monitors all rejected claims and constantly follow-up unit it’s paid based on the rejection reasons, this increases the cash flow rate for all MedHealthClaims service users.

With MedHealthClaims Rejection Management, you’ll be able to:

  • Reduce A/R days by claim analyzing, correcting and resubmitting claims online
  • Lower you administrative cost with MedHealthClaims because we are your single place for claims: Electronic, Paper, Primary, Secondary, Professional, and Institutional
  • 98% clean-claim rate with our highly technical staff and systems which gets you paid faster by eliminating rejections
  • Categorize rejected claims with our Categorized Reporting system we can easily identify and work your rejected claims easily and efficiently and quantify most common rejections so we can prevent them in the future.
  • We track every single foot step of the claims in order to get them paid completely with our dedicated staff members and research team


Payer Remittance & Payment Posting

Accurate & Effective management of your payments

MedHealthClaims expert team of payment posting will efficiently manage all your postings coming through electronic remittance advice (ERA), a digital version of the EOB’s and the manual postings which is explanation of benefits itself and takes efficient claims management to the next level by automating the process of receiving and posting payments.

With MedHealthClaims Electronic & Manual payment postings, you’ll be able to:

  • Patient & Insurance payments – We manage all the postings of the payments received from insurance and patient whether it electronic or manual
  • Automatically post ERA to HIPAA-compliant practice management systems
  • Eliminate data entry errors – Our expert team of payment postings make sure that every single penny is tracked and posted in to the system to manage your practice efficiently.
  • 100% paper less – By getting you enrolled with ERA payments we take your office 100% paper less so no more headaches of handling paper EOB’s and posting them, in fact we will
  • We track every single foot step of the claims in order to get them paid completely with our dedicated staff members and research team


Denial, A/R & Appeal Management

Increase profits and reduce cost

MedHealthClaims A/R team is an aggressive group of professionals who expertise in managing your denials, appeals and payments from one central location, not only this but also accelerate your revenue up to 20%

With MedHealthClaims Receivables team, you’ll be able to:

  • Claims appealing with MedHealthClaims, we will use pre-populated letters and payer forms to appeal for incorrect denied claims and get you paid easily
  • Find claims and payments quickly with our extensive search tools, using criteria most important to you.
  • Identify the most common denial reasons so that you can prevent them from happening in the future.
  • Easily research denied claims with access to both denial reasons and remarks.
  • Streamline your denial workflow with personalized work lists for role-based user-specific reporting that fits your practice.
  • Decrease days in A/R with powerful denial and appeal management tools that enable you to work smarter, not harder
  • Accelerate cash flow by using our online tool to submit secondary claims electronically



Patient Payment Solutions

Easy. Flexible. Convenient.

MedHealthClaims Patient Billing is your fast, convenient and cost-effective way to handle your patient statements and patient billing.

With MedHealthClaims Receivables team, you’ll be able to:

  • Increase cash flow by having patients pay their bills online.patient payment portal
  • Improve patient satisfaction with clear, concise patient statements
  • Reduce processing costs through consolidation of statement information onto one page
  • Patient follow-up’s – Our patient calling team stay in constant touch with your patient to guide and help them to clear their outstanding payments and getting providers paid ultimately.
  • Electronic patient billing system – Eliminate paper statements and mailing costs now in your office, because we are capable of making a doctor office go completely paperless and so we also manage to create and send patient statements electronically




MedHealthClaims Business Analytical Reporting, will help you to:

  • Spot rejection and denial trends
  • Identify and correct the root causes of ongoing problems by department
  • Focus the efforts of claims processing professionals
  • Build custom work lists to pinpoint systematic problems with razor sharp accuracy
  • Analyze current rejections by category and function: patient demographics, eligibility,coding, etc.
  • Gain valuable insights into how and when rejections occur, what the impacted dollar amounts are and which processes have improved by month, quarter or year-to-date

Prioritize claims for maximum revenue

  • Sort claims by rejection, denial code, payer, location, provider and more to mirror yourworkflow process
  • Work your way through the list, accessing claims with a single mouse click
  • Quickly identify and fix errors in high-dollar-value claims, then resubmit them with a single mouse click
  • Proactively manage outstanding claims to avoid cancellation due to failure to file in atimely manner




Top 5 reasons, how our revenue cycle manger will improve cash flow, reduce stress and gain profitability.

Reason 1: Your Practice WILL capture at least 20% more gross revenue

We are incentivized to capture the maximum amount of your earned revenue as we get paid on gross collections. Highly trained and credentialed billing experts work exclusively to improve the financial performance of your practice. Every claim, no matter how small, will be worked on until paid or a valid response for non-payment has been given.

Reason 2: Frequently Changing Regulations

Medical billing requires ongoing continued education. Staying current on insurance regulations, guidelines, laws and industry procedures ensure cleaner claims, and quicker settlements. Training your staff to stay current on how to properly schedule and process patients is just one way to assist your practice in collecting all monies due.

Reason 3: Labor Costs

MedHealthClaims will bear the entire burden of your collections and billing department. Our charge is less than your current expenses for staff and overhead. The net result is reduced payroll; payroll benefits, hiring and training, and zero staff turn-over and vacation days that interrupt billing flow and revenue cycle management. Additional time and money is saved through our processing, printing and mailing of patient statements. Furthermore, unburden your staff by eliminating patient billing phone calls and follow up on unpaid claims with insurance carriers.

Reason 4: Medicare and Medicaid

Nearly ½ of all patients seen in an average specialty practice are comprised of Medicare patients. Medicare reimbursements are continuously targeted by our Congress. Improving the efficiency of collections is vital. Dedicated specialists focus time and energy on billing to overcome these challenging times through increased revenue and profit.

Reason 5: No Capital Investment

Software, upgrades, training or billing systems not required. All billing is transparent, seamless and designed to get more money to the practice faster. Secure access to view financial reports at any time; checks and EOBs sent direct to office / bank account.