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MediClaims Inc. is  a  leader  in  providing  modern  healthcare  solutions  for  the 
healthcare industry. 
We endeavor to make start up easy for you and take the burden of reimbursement off 
from you and your staff. 
We  consider  your  success  as  ours  and  so,  we focus  on  helping  you  achieve  your 
financial goals. 
Every claim is important to us like every dollar is important to you. 
We possess a top team of billing specialists, certified coders, and account managers 
who  possess  extensive  expertise  in  billing  and  coding  services  across  several 
specialties. 
We  follow  a  continuous  process  of  encouragement  and  motivation  to  help  our 
workforce  to  be  able  to  reinvent,  respond  and  revolutionize  the  approach  to  our 
business.
 
We have a senior management team of highly experienced leaders who are an asset 
for our clients.
We are well versed with the latest technologies, but we believe that human skills are 
above all else. 
The  solution  to  more  efficient  practices,  better  collection  rates  and  greater 
profitability lies in how well you empower your staff to use technology to its full 
potential. 
We promise to play a major role in training your staff and provide superlative support 
round the clock.
  MediClaims  is  committed  to  complying  with  these  national  standards  to  protect 
individuals’ medical records and other personal health information.
Services
MediClaims  provides  comprehensive,  fully  integrated  medical  billing  solutions 
tailored to suit your needs regardless of the size of your practice. 
MediClaims  is  accurate,  reliable,  affordable  and  first  –  time  right,  to  ensure 
higher revenue, lower operational costs, valuable consultation time and reduced 
error rates.
Services provided by MediClaims
Medical Billing
Credentialing
Data Migration from one software to another
EDI Enrollment
Contract Negotiation
Patient Eligibility Verification
Obtaining Pre-Authorization from insurance
Demographics Entry
Medical Billing
Medical billing services have two integral parts:
 Insurance verification
 Authorization
In this, eligibility of patients to receive benefits is checked.
Strict verification is required before offering medical services to the patients; else
patients will not receive the payment of claims.
Such types of mismanagement can lead to huge loss for the office.
The insuring agency should be called for verification of eligibility or else online
verification can be done. Medical billing and coding experts work together to handle
patient insurance claims.
Our medical billing verification process involves verification of:
Payable benefits
Deductibles
Patient details
Plan type
Mailing address of the claim
Coverage details
Pre-authorization number
 Referrals
Life time maximum
Patient policy status
Co-pays and many more
Medical billing company
Benefits of Hiring MediClaims Inc:
 Simplify your work flow
Reduce claim rejections
Speed up billing cycles
Minimize delays considerably
Provide quick insurance verification and authorization
Enhance revenue cycle
Reduce rework of claims
Increase efficiency of office and economies of scale
Free up your workforce to focus on more productive tasks
 Reduce risk factors
Improve payment and collections
Lower bad debt write-offs
Help improve staff productivity
Reduce your operational costs
 Save your time
Simplify your billing process
Reduce your effort and time
Help increase patient satisfaction
Reduce overheads
Credentialing
MediClaims Inc. is dedicated in providing outstanding credentialing services to all
health care providers.
With MediClaims credentialing services you will be able to:
Eliminate redundant paperwork and errors.
Fully concentrate on patients than unnecessary credential duties.
Gain access to preferred insurance networks quickly and efficiently with our specialized
credentialing services.
Divert valuable staff to other areas of concern than get involved in credential work
We provide commitment, confidentiality, consistency and accuracy in all aspects of
medical credentialing. We give special attention to detail.
Professionals of medical field can rely on MediClaims Inc. to provide you with the
peace of mind that all verification and payment verification processes go smoothly.
MediClaims Inc. is a leader in medical credentialing. MediClaims Inc. caters to the
demands of physicians by understanding the criticality of proper credentialing.
Data Migration
MediClaims Inc. offers data migration services from one software to another, in case of
installation of new software or updating of existing software.
We perform this by a set of customized scripts or programs that can automatically
transfer the data.
We follow the following steps to ensure perfect data migration:
Do proper planning.
Allocate the best people from our organization.
Employ an independent consultant.
Have qualified migration staff.
EDI Enrollment:
Through EDI enrollment, Mediclaims helps improve your efficiency. We help you to
streamline information flow, reduce workload from administrative tasks and raise
productivity and profit.
Contract Negotiation:
Negotiating contracts with insurance companies is a difficult task for the physicians and
every time, instead of the physicians, the insurance companies extract maximum benefit
from the physicians.
At MediClaims contract negotiation service, we focus on 5 key elements:
Compensation - Whether you are fairly compensated? Under the terms of the agreement, whether
you will be able to earn incentive compensation?
Call and Schedule - What are your call and coverage obligations?
Benefits - What benefits you are offered by the employer? We ask for additional benefits.
Restrictive Covenants - Will you be able to practice in your area even after your employment ends?
Termination and terms - What are the provisions of termination? What is the exact term of your
employment agreement?
The benefits of MediClaim Contract Negotiation service:
Help you receive top money for your services
Reduce hidden obligations and liabilities in your existing contract
Speed up your insurance reimbursements beyond belief.
Help you have an edge over your competitors
Reduction in limitations on your hiring decisions
Help you prevent from giving away discounts you don’t intend to give.
Help you achieve continuous revenue improvements.
At MediClaim, we try our level best to formulate ways to improve your income. We
follow a perfect feedback system about your current contract and how to avoid
unnecessary risks.
Patient Eligibility Verification:
To complete the crucial patient eligibility verification processes with accuracy,
MediClaim Inc. is equipped with advanced technology and skilled workforce.
We provide all the assistance required to complete your verification tasks and
appointment scheduling.
We cover the following processes:
Verify patient’s insurance coverage
Receive patient schedules
Update the billing system with eligibility details
Contact patients, if required
We would complete the entire insurance eligibility verification process for all scheduled
appointments right before the patient appointment date.
This would assist you in allocating more time to your major healthcare activities:
Patient satisfaction is increased
Class flow is enhanced
Revenue cycle is enhanced
Claim rejection is reduced
Overhead is reduced
Efficiency is increased
Workflow is simplified
Approval and authorization is achieved very fast
Billing cycles are made faster
Obtaining Pre-Authorization from insurance:
Many healthcare insurers have pre-authorization policies. To address this, MediClaims
Inc. follows a pre-authorization procedure.
Our procedure is as follows:
We first of all contact the insurance company for authorization number. We make sure
that the information received from them matches our records
If the physician’s office has not obtained authorization we politely inform them that they
must get it before their patient can have their procedure
We always follow-up with the insurance company. If possible, we request a fax of the
approved authorization for the records
If a procedure changes or something is added at the last minute, we contact the insurance
company as soon as possible to add the changes to the authorization
We understand that each insurance company has their own guidelines and what is not
required for one may be required for another.
Demographics Entry
MediClaims Inc. patient demographics entry sheet (face sheet of a claim or charge)
contains:
Name of the patient
Address
Date of birth
Doctor’s information
Phone number
Gender
Social security number (SSN)
Information for emergency contact
Guarantors
Health insurance information
Marital status
Demographic Entry Process – Flow Chart
707 York Road,Apt#5123
Townson, Mad21204

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Mediclaims Inc

  • 1.
  • 2. MediClaims Inc. is  a  leader  in  providing  modern  healthcare  solutions  for  the  healthcare industry.  We endeavor to make start up easy for you and take the burden of reimbursement off  from you and your staff.  We  consider  your  success  as  ours  and  so,  we focus  on  helping  you  achieve  your  financial goals.  Every claim is important to us like every dollar is important to you.  We possess a top team of billing specialists, certified coders, and account managers  who  possess  extensive  expertise  in  billing  and  coding  services  across  several  specialties.  We  follow  a  continuous  process  of  encouragement  and  motivation  to  help  our  workforce  to  be  able  to  reinvent,  respond  and  revolutionize  the  approach  to  our  business.  
  • 3. We have a senior management team of highly experienced leaders who are an asset  for our clients. We are well versed with the latest technologies, but we believe that human skills are  above all else.  The  solution  to  more  efficient  practices,  better  collection  rates  and  greater  profitability lies in how well you empower your staff to use technology to its full  potential.  We promise to play a major role in training your staff and provide superlative support  round the clock.   MediClaims  is  committed  to  complying  with  these  national  standards  to  protect  individuals’ medical records and other personal health information.
  • 4. Services MediClaims  provides  comprehensive,  fully  integrated  medical  billing  solutions  tailored to suit your needs regardless of the size of your practice.  MediClaims  is  accurate,  reliable,  affordable  and  first  –  time  right,  to  ensure  higher revenue, lower operational costs, valuable consultation time and reduced  error rates.
  • 5. Services provided by MediClaims Medical Billing Credentialing Data Migration from one software to another EDI Enrollment Contract Negotiation Patient Eligibility Verification Obtaining Pre-Authorization from insurance Demographics Entry
  • 6. Medical Billing Medical billing services have two integral parts:  Insurance verification  Authorization In this, eligibility of patients to receive benefits is checked. Strict verification is required before offering medical services to the patients; else patients will not receive the payment of claims. Such types of mismanagement can lead to huge loss for the office. The insuring agency should be called for verification of eligibility or else online verification can be done. Medical billing and coding experts work together to handle patient insurance claims.
  • 7.
  • 8. Our medical billing verification process involves verification of: Payable benefits Deductibles Patient details Plan type Mailing address of the claim Coverage details Pre-authorization number  Referrals Life time maximum Patient policy status Co-pays and many more Medical billing company
  • 9. Benefits of Hiring MediClaims Inc:  Simplify your work flow Reduce claim rejections Speed up billing cycles Minimize delays considerably Provide quick insurance verification and authorization Enhance revenue cycle Reduce rework of claims Increase efficiency of office and economies of scale Free up your workforce to focus on more productive tasks  Reduce risk factors Improve payment and collections Lower bad debt write-offs Help improve staff productivity Reduce your operational costs  Save your time Simplify your billing process Reduce your effort and time Help increase patient satisfaction Reduce overheads
  • 10. Credentialing MediClaims Inc. is dedicated in providing outstanding credentialing services to all health care providers. With MediClaims credentialing services you will be able to: Eliminate redundant paperwork and errors. Fully concentrate on patients than unnecessary credential duties. Gain access to preferred insurance networks quickly and efficiently with our specialized credentialing services. Divert valuable staff to other areas of concern than get involved in credential work We provide commitment, confidentiality, consistency and accuracy in all aspects of medical credentialing. We give special attention to detail. Professionals of medical field can rely on MediClaims Inc. to provide you with the peace of mind that all verification and payment verification processes go smoothly. MediClaims Inc. is a leader in medical credentialing. MediClaims Inc. caters to the demands of physicians by understanding the criticality of proper credentialing.
  • 11. Data Migration MediClaims Inc. offers data migration services from one software to another, in case of installation of new software or updating of existing software. We perform this by a set of customized scripts or programs that can automatically transfer the data. We follow the following steps to ensure perfect data migration: Do proper planning. Allocate the best people from our organization. Employ an independent consultant. Have qualified migration staff.
  • 12. EDI Enrollment: Through EDI enrollment, Mediclaims helps improve your efficiency. We help you to streamline information flow, reduce workload from administrative tasks and raise productivity and profit.
  • 13. Contract Negotiation: Negotiating contracts with insurance companies is a difficult task for the physicians and every time, instead of the physicians, the insurance companies extract maximum benefit from the physicians. At MediClaims contract negotiation service, we focus on 5 key elements: Compensation - Whether you are fairly compensated? Under the terms of the agreement, whether you will be able to earn incentive compensation? Call and Schedule - What are your call and coverage obligations? Benefits - What benefits you are offered by the employer? We ask for additional benefits. Restrictive Covenants - Will you be able to practice in your area even after your employment ends? Termination and terms - What are the provisions of termination? What is the exact term of your employment agreement?
  • 14. The benefits of MediClaim Contract Negotiation service: Help you receive top money for your services Reduce hidden obligations and liabilities in your existing contract Speed up your insurance reimbursements beyond belief. Help you have an edge over your competitors Reduction in limitations on your hiring decisions Help you prevent from giving away discounts you don’t intend to give. Help you achieve continuous revenue improvements. At MediClaim, we try our level best to formulate ways to improve your income. We follow a perfect feedback system about your current contract and how to avoid unnecessary risks.
  • 15. Patient Eligibility Verification: To complete the crucial patient eligibility verification processes with accuracy, MediClaim Inc. is equipped with advanced technology and skilled workforce. We provide all the assistance required to complete your verification tasks and appointment scheduling. We cover the following processes: Verify patient’s insurance coverage Receive patient schedules Update the billing system with eligibility details Contact patients, if required
  • 16. We would complete the entire insurance eligibility verification process for all scheduled appointments right before the patient appointment date. This would assist you in allocating more time to your major healthcare activities: Patient satisfaction is increased Class flow is enhanced Revenue cycle is enhanced Claim rejection is reduced Overhead is reduced Efficiency is increased Workflow is simplified Approval and authorization is achieved very fast Billing cycles are made faster
  • 17. Obtaining Pre-Authorization from insurance: Many healthcare insurers have pre-authorization policies. To address this, MediClaims Inc. follows a pre-authorization procedure. Our procedure is as follows: We first of all contact the insurance company for authorization number. We make sure that the information received from them matches our records If the physician’s office has not obtained authorization we politely inform them that they must get it before their patient can have their procedure We always follow-up with the insurance company. If possible, we request a fax of the approved authorization for the records If a procedure changes or something is added at the last minute, we contact the insurance company as soon as possible to add the changes to the authorization We understand that each insurance company has their own guidelines and what is not required for one may be required for another.
  • 18. Demographics Entry MediClaims Inc. patient demographics entry sheet (face sheet of a claim or charge) contains: Name of the patient Address Date of birth Doctor’s information Phone number Gender Social security number (SSN) Information for emergency contact Guarantors Health insurance information Marital status
  • 19. Demographic Entry Process – Flow Chart