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Medisoft Electronic Claims

RelayHealth is a McKesson wholly owned clearinghouse offering Electronic Claims, Electronic Remittance Advice and Insurance Eligibility Verification. Most clearinghouses will work with Medisoft, however, there is only one clearinghouse that is integrated right into your own billing program - RelayHealth. This is important because it means you will not have to export data, map any forms, or manage your claims in another system.

Having a clearinghouse owned by the maker of Medisoft (McKesson) insures a total commitment to long term innovation.

We will partner in your success

Medworks will walk you through the process of integrating your Medisoft with RelayHealth. We will make it easy for you! This is what you can expect:

  • We will provide you with official paperwork for your authorization.
  • We will send your paperwork to McKesson for processing and activation.
  • Once your account is activated, Medworks will schedule an appointment with you to guide you through set-up, and train you on how to submit claims, receive reports, etc.
  • If claims are rejected, we have the tools and knowledge to help you fix the problem. Yes, we will partner in your success!

Revenue Management Demo


Medisoft Revenue Management is a software tool that expands the EDI capabilities of Medisoft. Physician practices can use Revenue Management to electronically connect to clearinghouses like RelayHealth as well as directly to payors.

 

Click Here to View a Demo

RelayHealth: Just the Facts

Collecting revenue in a timely manner is critical to financial performance. As the market leader in healthcare connectivity services, nobody understands this better than RelayHealth. Here are the facts about RelayHealth:

  • Operates the second largest claims clearinghouse in the US
  • Processes 1.48 billion claims, remittance and eligibility transactions annually
  • Connects with more than 1,800 payors nationwide

For more information or to sign up call Medworks at 973.543.8600

Introducing Medisoft Revenue Management

The newest name in claim management can help you get paid faster. Check your claims before you send them and speed up reimbursement*!

Medisoft Revenue Management is a software tool that expands the EDI capabilities of Medisoft. Physician practices can use Revenue Management to electronically connect to clearinghouses like RelayHealth as well as directly to payors. There are two Revenue Management options:

  • Revenue Management Advanced: Uses RelayHealth to connect to payors and offers integrated eligibility, pre-claim edits for claim scrubbing, ERA processing, and integrated report viewing and claim status management.
  • Revenue Management Direct: Connects directly to payors or to clearinghouses other than RelayHealth. Includes pre-claim edits for claim scrubbing, ERA processing and report management.

* With Medisoft Revenue Management intense scrubbing of your claims finds errors before they are even sent for payment. Imagine eliminating the manual work to correct and re-file every claim that gets rejected. If a claim is sent correctly the first time you receive payment faster.

Key Features

  • Creates professional and institutional claims to payors accepting HIPAA-compliant ANSI 837 formats.
  • Sends claims direct to the insurance carrier or clearinghouse of your choice including RelayHealth.
  • Includes 835 ERA remittance auto-posting.
  • Includes automatic secondary claim creation for either ERA-posted or hand-keyed primary insurance posting.
  • Maintains complete history of all actions taken on a claim.
  • Includes robust reporting capabilities including the ability to easily view, print, export and email reports.
  • Includes billing-defined and user-defined pre-claim edits in the core application. An optional claim editing module is available as an add-on to provide additional pre-claim edits including Medicare Policy Edits, CCI Edits, CPT and Diagnosis Codes, Global Periods and Common Edits.

When a biller clicks the Print/Send button in Medisoft, the Revenue Management Claims screen opens. The biller is able to check the claims against pre-claim edits. Color-coded flags indicate whether a claim has passed the edits, has an error or has a warning message. The biller then chooses a patient on the screen to drill down and view the warning message and all actions taken on the claim including services, history and edits before the claims are submitted for payment.

Improve your revenue cycle and call 973.543.8600 to order Medisoft Revenue Management.

Improve the Revenue Cycle with RelayHealth

Collecting revenue in a timely manner is critical to financial performance. This is what RelayHealth does best. It also reduces your labor costs, is easy to use, and comes at an affordable price. RelayHealth:

  • Eliminates most manual claims and remittance processing.
  • Processes claims with unprecedented ease, speed and accuracy
  • Instantly determines patient insurance eligibility
  • Submits electronic claims to more than 1,800 payors, and returns an electronic remittance advice (ERA) from many payors as well. No more waiting for paper EOBs mailed to your office!
  • Helps you stay current on payor rules for more successful claims submissions.
  • Integrates BillFlash (set-up link), a patient statement processing service provided by partner NexTrust, to save your billing staff from performing this time consuming and inefficient task.

With the click of a button, RelayHealth lets a practice transmit a full day's schedule to obtain eligibility information from most payors; responses retrieved directly from the payors offer accurate and up-to-date information. This not only saves time by eliminating lengthy phone calls to payors, but accelerates cash flow by enabling immediate patient collection payment for any treatment not covered by insurance.

Electronic claims and remittance processing enable accurate claims submissions and help reduce rejected claims. Filing electronic claims also ensures payment in half the time of paper claims. Once through the payor's system, the practice receives notification of what the payor will pay on the claim in an electronic format.

For more information or to sign up call Medworks at 973.543.8600