EDI Direct

Agency connectivity and X12 file translations are done in-house for eligibility (270/271) and Electronic Remittance Advise (ERA/835) analysis; Medicom is itself a certified clearing house vendor, saving time and expense by not having to rely on other 3rd party data vendors.

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Medicom also specializes in claims management advisory services. The 837 claims data is ran through a series of proprietary edits and filters for purposes of pinpointing problem areas before the bill processing cycle ensues. Opportunities in this service includes the identification of technical entry level rejections, weak input elements leading to claims denials, and underpaid reimbursement levels resulting from less than optimal pairing of service and billing codes.