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

Categories

Solutions

Description

Product Description:
MedData Military Payers Billing & Follow Up Services can provide comprehensive collection and follow-up services on all patient accounts referred to us that have the potential for reimbursement from the Veterans Administration (VA), TriCare, TriWest, and CHAMPVA. Our VA leadership team, which includes the former operational head of Veterans Integrated Services Network (VISN), conducts regular on-site meetings or conference calls with the claims processing representatives. We are able to work with them one on one and often get same-day resolution. This service can include everything needed to transmit the bill and obtain reimbursement for the client, including: • Coordination of benefits to ensure billing of the proper primary payer. • Running the claim through our found insurance program to determine eligibility on other payer sources. • Upon final bill, transmitting the required billing information to the VA according to the guidelines established by the appropriate VA local office. • Implementing tracking procedures to ensure that both transmission and receipt of the billing information can be confirmed. • Follow-up on the bills until the account has been paid or denied. • Follow-up on claims through established conference calls with VA. • Face-to-face claim resolution meetings with VA (frequency depends on volume of claims pending with particular VISN). • Reviewing the account to ensure that the payment received was the proper amount. • If the account is denied or the amount paid was not the proper amount, appeal the account through the VA appeal system. • Working through batches of accounts alongside VA personnel onsite at the VISN. • Submitting claims with proper documentation in the proper order. • Pursuing the account through to resolution. • Providing reporting on the referred inventory.
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:

There is a different way to work. If you were to reimagine the way you run your business, what would you do differently? What if you could save up to 80% of your operational costs by reimagining the way business outcomes are delivered?

Through the power of automation emerging technologies, we challenge you to think differently about how you work and how you use your people to full effective.

We can help you across the automation journey from thinking through your strategy to implementing and executing robotic process automation, machine learning and other emerging technologies across the enterprise.  

Revenue Cycle Management:

Prior Authorization ​

Insurance Claims - Posting

Patient Payment - Posting

Coordination of Benefits: Primary, Secondary, & Tertiary

Revenue Integrity - Payment Audits (Under & Over)

Provider: Insurance Enrollment

Revenue Integrity - Charge Description Master (CDM) Management

Revenue Integrity - IME or IMR Audits (CMS & Medicare Advantage)

Insurance Claims - Denied & Rejected Follow-Up

About TQA Healthcare - Formerly Element Blue:

TQA Healthcare enables healthcare and life sciences organizations to transform the patient experience and reduce costs through increased personalization, intelligent automation, and AI. 

The practice’s solutions impact patient access, the revenue cycle, order processing, and clinical needs at the most critical stages of the patient journey, resulting in a seamless encounter.

By empowering individuals to actively manage their unique experiences, TQA Healthcare increases the satisfaction of every healthcare consumer: patients, staff, and clinicians.

Houston-based, TQA Healthcare is formerly Element Blue. 

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:
  • Prior Authorization
  • Claims Status
  • Coding
  • Scheduling
  • HIM
  • Remittance Posting
  • Provider Credentialling
  • Accounts Payable
  • Human Resources
  • Clinical Services
  • Patient Access
  • Revenue Cysle Management 
  • Supply Chain
  • Finance
  • HR
  • Referrals
  • Faxes
  • PDFs
  • Emails
  • Scans
  • Invoices
  • Patient Charts
  • Patient Records
  • Lab Orders
  • Mail
  • Paper Documents
  • Resumes
Pediatric use cases:

Same as for any health system, but additional applications related to newborn insurance and patient proxy for infants and children.

Users:

Revenue Cycle Leaders

Finance Leaders

IT Leaders

HR Leaders

HIM Leaders

Operations Leaders

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, ERP system, Patient portal, Pop health platform, Home health, Behavioral health, Community based organizations, ADT, Access +/or revenue cycle, Credentialing, Website / public online sources, Other

EMR Integration & Relevant Hardware:

Not applicable

EMRs Supported:

Epic, Cerner, Meditech, Allscripts, NextGen, athena, GE, eClinicalWorks, McKesson, Other, Allscripts/Eclipsys, Athenahealth, Azalea Health/Prognosis, CPSI, Evident, Healthland, MEDHOST, MedWorx, QuadraMed, Self-developed, Would prefer not to disclose, Point Click Care

Hardware Compatibility:

Not applicable

Client Types

Awards

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Differentiators

Differentiators vs EHR Functionality:

None provided

Differentiators vs Competitors:

None provided

Differentiators vs EHR Functionality:

While EHRs offers integration tools, achieving seamless data exchange, particularly with non-EHR systems, can be challenging due to their limited interoperability.

This can create communication hurdles between providers using different EHRs, healthcare facilities not on a particular EHR, and providers who need to integrate with other advanced technology platforms outside of the EHR ecosystem.

Element Blue's solutions can integrate with any platform and are independent of particular products or technologies. This affords our teams unlimited creativity when ideating custom solutions for each healthcare organization.

Differentiators vs Competitors:

Element Blue's practice is dedicated exclusively to healthcare and life sciences. This is unique among our UiPath competitors, who serve multiple industry verticals.

A UiPath Platinum partner, Element Blue is recognized as a leading systems integrator with more than 20 years' experience in working with some of the world's best known providers, payers, diagnostics, and life sciences organizations.

Keywords

Images

1 of 1

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Videos

No videos provided

1 of 3

Epic Claim Denial Resubmission with BCBS.mp4

Downloads

No content provided

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66329_EB RPA Case Study REVISED.pdf

Alternatives

Company Details

Founded in 1980

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