Services

Financial Services

Mediture is electronically connected to Emdeon through industry standard ASC X12N 837 and 835 transaction sets, allowing the entire process to be completed electronically.

Adjudication and Claims Processing

  • Ability to receive 5010 format 837p or 837i claims in TruChart through Emdeon hub connection
  • Key in data received from external HCFA 1500s, UB04, ADA dental claims and invoices directly into TruChart LIFE
  • Automatically matches the claim with Service Authorizations in TruChart
  • Mediture loads and maintains Medicare and Medicaid fee schedules, including: RBRVS, CCI Edits, Fee Periods, Physicians, Labs, DME, DME Parenteral, Ambulance, Anesthesia and Drug fee schedules.
  • Vendor Management database tracks a Provider’s demographics, NPI numbers, Tax ID numbers, contract dates and in or out of network status.
  • Auto-adjudicate claims against contracted rate and flag claims for pended status
  • Flags coding errors and mutual exclusion edits
  • Generate 835 remittance advice, Explanation of Payments (EOP) with remark codes that will adjust the claim
  • Generate denial letters with remark and adjustment reasons to be sent to providers
  • 24×7 monitoring and management of connectivity
  • Provide data export/import capabilities with PACE program’s Accounts Receivables and Accounts Payable system.

5010 Encounter Data System Management

  • Capture PACE staff face to face encounter data – E&M CPT coding – to support 5010 reporting requirements
  • Generate Encounter Data reports
  • Build custom encounter data report file formats for state specific requirements
  • Technology tools for combining internal encounter data with claims data from professional and institutional claims
  • Direct connect to CSSC FERAS for submission of EDS data to CMS
  • Edit file processing for re-submittal

Risk Adjustment

  • Track PACE Center staff encounters with diagnosis codes, date of service, place of service, provider and patient data
  • Data mine external claims for encounter data
  • Direct connect to CSSC FERAS for submission of RAPS data to CMS
  • Edit file processing for re-submittal

Cloud Model Hosting Services

Mediture will host the resources necessary to support the operation of various healthcare and non-healthcare software programs (Practice Management Systems, Electronic Health Records, etc.) for PACE organizations. The necessary support software and operating systems are installed on a server in a centrally based hosting facility. Clinics access their software through standard Windows Desktop Remote. Redundant computer, network and power systems help to assure maximum accessibility. Maintenance provided by Mediture includes data back-up, software upgrades, installation of all PMS, EHR, and OS Patches, as well as complete system health and monitoring of all systems.

Hosting Solutions by Mediture Include:

Client access to hosted applications is through Microsoft Terminal Services (Microsoft Desktop Remote)

  • iSCSI storage over GigE (SAN)
  • 50GB of on-line storage and 50GB of backup
  • Internet access setup and connection (at data center, not at clinic site)
  • Initial site set-up
  • Installation of all PMS, EHR, and OS patches
  • Server and monitoring installation
  • Hardware maintenance
  • Physical hosting
  • Uninterruptible power supply
  • Antivirus protection
  • Complete data back-up
  • Networking
  • System administration
  • System health and monitoring
  • Remote testing of on-site Devices through Windows Desktop Remote (scanners, printers, etc.)

Key attributes of Mediture’s Healthcare IT Services:

  • Complete system monitoring and status of all systems
  • Mediture has two separate data centers in Minnesota and one data center in
  • Colorado to add geographical diversity. The data centers require biometric access to enter. All servers and storage devices are housed within video monitored locked cages and cabinets.
  • Redundant computer, network and power systems will help assure maximum accessibility
  • Clinic access through standard Windows Desktop Remote (clinic may optionally request Citrix Remote)
  • Trained staff with extensive healthcare systems knowledge. Mediture supports end-to-end functionality that sometimes requires PM or EHR application support

I.T. Support

  • Remote / phone support (Help Desk)
  • Onsite response
  • 24 x 7 availability with emergency response
  • Remote monitoring
  • Backups
  • Security
  • Spam filtering
  • PC and printer support
  • Server and network diagnosis
  • Backup and antivirus support
  • Remote connectivity to your computer