HIP One harnesses advanced AI and GenAI capabilities, enhancing the productivity of clinical and business operations teams by an impressive 30-50%. The platform’s built-in security, privacy, and compliance ensures that innovation is delivered responsibly and in full adherence to industry standards. By delivering comprehensive, integrated solutions, HIP One eliminates the need for building point-specific tools. That’s because each module within HIP One is purpose-built to address multiple use cases, including: Prior Authorization (PA) Utilization Management (UM) Case management (CM) Medical Reviews

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.

Built by domain experts in specific claim and prior authorization types

Flexible commerical structure

Platform capability vs point solution