We understand the challenges our clients face in today's healthcare environment and the complexities of the Chargemaster, Defensible Pricing strategies and Medicare regulations. We offer a scope of consulting services and technology products that can provide customized solutions to critical issues such as maintaining regulatory compliance, optimizing reimbursement, improving accuracy of billing and educating staff about coding updates and how to charge for services.

MedCom's in-depth consulting knowledge blended with proprietary software allows for a Chargemaster and Order Entry review that is expert, actionable, and provides for a significant return on investment to the client.

MedCom conducts a systemized audit to review the mappings of up-front Order Entry systems to the Chargemaster, resulting in accurate charge capture and reimbursement for all services provided.

Specialized clinical consultants review current charging practices, and identify and correct problem areas, resulting in accurate reporting of services and enhanced revenues from missed charges.

MedCom has both software technologies and outsourcing options for Chargemaster Management, providing in-depth expertise and tools to create a program that will ensure that your Chargemaster is accurate, compliant, and provides continued revenue improvements.

MedCom develops customized education and training programs, tailored to our client's needs, that provide the tools for the staff to correct coding and charging practice issues, and to maintain the Chargemaster.

Audits, on CPT (or APC) code basis, the actual payment compared to the fee schedule amount.

Provides detailed cash reconciled reporting by cost report classification by provider for any given period of time.

MedCom's ABN technology provides a unique solution to the issue of ABN screening by delivering real-time verification of medical necessity as well as ABN generation for both professional and technical environments.

Provides post-payment audit pursuant to Section 8(b) of the 016-Settlement Agreement.

Provides audit of intra-system patient transfers to identify transfer vs. discharge status based on common dates.

Electronic UB-92 audit of ICD-9 to CPT codes to examine the compatibility to medical necessity regulations.

Find all the regulatory updates that you need with one easy-to-use tool.

MedCom financial consultants work with your finance team to develop line-by-line pricing recommendations that ensure defensibility, address revenue needs, and are easily implemented.

MedCom financial consultants explore high-level pricing defensibility and opportunities through an analysis of your current pricing strategy and modeling of possible new approaches.

MedCom reviews critical aspects of pricing defensibility through a series of electronic data queries, pinpointing key areas where a detailed review is warranted.

MedCom provides an evaluation of key inpatient and outpatient price benchmarks for your facility versus your chosen competitors.

MedCom's internal software application, Pricing Strategist, can be separately licensed in order for your facility to benefit from the flexibility to model pricing scenarios and measure defensibility metrics.