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Description
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Use cases
EHR integrations
Client types
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Health equity
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Jump to:
Categories
Solutions
Description
Compatibility Level
Clients
Use cases
EHR integrations
Client types
Differentiators
Health equity
Keywords
Media
Company details
XpertCoding
XpertCoding

Categories

Solutions

Description

Product Description:
MedData’s Denials Management Outsourcing Services improves your business office’s effectiveness by allowing it to concentrate on areas of the revenue-generating process that have a higher yield and do not distract hospital account representatives from their primary duties. We have dedicated specialists who focus on denials management nationwide with extensive experience working with ALL payer types, scenarios and denial reasons. MedData provides invaluable feedback to help the hospital improve its approach to the denial management process. We provide reports on a monthly basis (or as needed) that track payer, denial type, service, and physician’s issues. This helps our clients improve their internal processes that in turn will lead to long-lasting gains in Accounts Receivable performance. MedData works all denial types including: • Lack of Authorization • Insufficient Authorization • Medical Necessity • Unresponsive Recoupments • Coverage Exclusions • Pre-existing Condition • Coordination of Benefits • Timely Filing • Subrogation\Accident Details • All Denial types (administrative/clinical) MedData also has a dedicated focus on unresponsive patient denials (UPDs), which consist of any denial type where the patient’s and/or subscriber’s involvement is required in order to secure resolution on the claim. Our service helps prevent these denials from getting lost in self-pay and ending up in bad debt. UPDs include, but are not limited to: • Coordination of Benefits (COB) • Pre-existing questionnaires • Incident letters • Accident letters • Adding newborns to policies • Subrogation forms • Authorizations • Any other time a patient’s involvement is required by the insurer The benefits of utilizing MedData to perform your denials management is that we have the following performance drivers: • Dedicated RNs on staff for medical necessity reviews, peer to peer coordination, etc. • Primary focus on Commercial and Medicare/Medicaid claims • Strategic focus and prioritization based on dollar balance and/or potential reimbursement, age, and timely filing requirements • OCR capabilities for digitalization of hard copy remits/EOBs • Dedicated compliance team and internal legal resource with nationwide legal partnerships • We aggressively work the account until it is 100% resolved • Complete “feedback loop” to prevent future denials through a rigorous root cause analysis process • Close coordination with contracting department to ensure compliance and provide insight for future contracting • Overturn denials through the appeal processes when necessary • Incoming and outgoing call campaign with the patient • Patient texting capability • Streamlined patient letter series • Skip trace with three levels of escalation
About MedData:

MedData has been a tenured and trusted healthcare revenue cycle management services provider for more than 40 years, delivering technology-enabled and patient-focused RCM solutions, including Eligibility & Disability, Accounts Receivable Services (ARS), Injury Accounts (Workers’ Comp, Auto, etc.), Veterans Administration, Patient Responsibility/Early Out, COB Denials, and Out-of-State Eligibility. MedData has patient advocates from coast to coast and experience with hospitals and health systems of all types – large to small, rural to urban, nonprofit to for-profit – giving the company a nationwide presence with a local feel that’s scalable to any volume. Click the "Files" tab for downloadable content with more information about our organization.

Product Description:

XpertCoding uses advanced AI, NLP, and RPA technologies to automate over 90% of medical coding tasks, processing claims within 24 hours. XpertCoding's AI-powered coding system maintains a 98% accuracy rate and reduces coding costs by over 50%. 

XpertCoding also includes a Business Intelligence suite with a Clinical Documentation Improvement (CDI) Dashboard and a Comprehensive Data Analytics Dashboard, providing essential insights for healthcare leaders and teams to optimize operations.

About XpertDox:

XpertDox is a healthcare technology company committed to reducing administrative burdens for physicians, healthcare teams, and leaders while enhancing patient care through AI-driven solutions. XpertDox employs AI, RPA, and Big Data technologies to improve healthcare outcomes.

XpertDox's commitment to innovation is demonstrated by its flagship product, XpertCoding, an autonomous medical coding software with Clinical Documentation Improvement(CDI) designed to accelerate the revenue cycle by processing medical claims with high accuracy in less than 24 hours.

XpertDox was founded in 2015 and is currently based in Scottsdale, Arizona.

Compatibility level

Select which hospital or health system you work at and see a personalized compatibility level.

Clients

Select which hospital or health system you work at and see the client list

Use Cases

Description:

None provided

Pediatric use cases:

None provided

Users:

None provided

Description:
  1. Healthcare systems, hospitals, and practices can harness XpertCoding to expedite claim submissions, boost accuracy, reduce costs, and alleviate physician burden.
  2. RCM companies can utilize XpertCoding to expedite claim processing, improve accuracy, and deliver cost savings for their clients.
Pediatric use cases:

XpertCoding is implemented at multiple pediatric practices where it automates the medical coding process.

Users:
  • Urgent Cares
  • Pediatric Practices
  • Primary Care Practices
  • Obstetrics & Gynecology Practices
  • Healthcare Systems
  • Hospitals with large urgent care, pediatrics or primary care presence
  • Any other medium to large single-specialty practices

EHR Integrations

Integrations:

None provided

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

None provided

Hardware Compatibility:

None provided

Integrations:

Acute care EMR, Ambulatory EMR, Ancillary EMR

EMR Integration & Relevant Hardware:

Required

EMRs Supported:

Epic, Cerner, Meditech, Allscripts, NextGen, athena, GE, eClinicalWorks, McKesson, Other, Allscripts/Eclipsys, Athenahealth, Azalea Health/Prognosis, CPSI, Evident, MEDHOST, MedWorx, Healthland, QuadraMed, Self-developed

Hardware Compatibility:

Not applicable

Client Types

Differentiators

Differentiators vs EHR Functionality:

None provided

Differentiators vs Competitors:

None provided

Differentiators vs EHR Functionality:
  1. XpertCoding is an AI-powered, fully autonomous medical coding solution, whereas EHRs only offer computer-assisted coding that requires provider input and a coding team.
  2. XpertCoding provides a Dashboard to monitor claims and perform advanced analytics across all their location, whereas EHRs do not offer a coding-focused Dashboard.
  3. XpertDox offers a Clinical Documentation Improvement module not offered by most EHRs.

Differentiators vs Competitors:
  1. XpertCoding can autonomously code >90% of the claims, whereas competitors may only code 60 to 80%.
  2. XpertCoding offers free coding services for one month, whereas most competitors don't.
  3. The training period for XpertCoding is less than four weeks, compared with many months and even a year with some competitors.
  4. XpertCoding offers a comprehensive Dashboard for monitoring, data analytics, CDI, and audit trail. The competitor's Dashboard may or may not be as robust.
  5. XpertCoding does not require any IT support from clients, whereas many competitors require some help from the IT team.
  6. XpertCoding is HIPAA, ISO27001, and SOC2 Type 2 certified from a security perspective, whereas some competitors do not carry such certifications.
  7. XpertDox is ISO22301 certified for business continuity, whereas some competitors may not have the certification.

Health Equity

Keywords

Images

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Videos

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Downloads

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XpertDox-White Paper_PatientDataProtection.pdf

Alternatives

Company Details

Founded in 1980

Founded in 2015

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