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What is mDOC?

Using our claims listing page allows you to quickly rectify any inaccuracies or missing information prior to submitting your claims. Once all essential data is inputted and the necessary diagnosis and modifier codes are included, you can smoothly upload a batch of claims to Trizetto Provider Solutions® with just one click. After this step, Trizetto Provider Solutions® performs another thorough review of the claims before sending them to the appropriate payers. When insurance companies process the payments, you will receive updates on the claims that show allowed amounts, adjustments, copays, coinsurance, and deductibles. To ensure accuracy, payments are recorded in groups. Statements are generated based on your chosen frequency—whether that’s daily, weekly, or monthly—and are crafted in a clear format that patients can easily understand. This transparency significantly reduces any previous misunderstandings! In addition, the statement includes a section for credit card authorization, making it easier for patients to settle any outstanding balances and ensuring a seamless payment experience. This thoughtful approach not only enhances patient satisfaction but also streamlines your financial operations.

What is Inovalon Claims Management Pro?

Achieve a consistent revenue flow by leveraging a powerful platform designed to expedite reimbursements through eligibility checks, claims status monitoring, audit and appeal processes, and remittance management for both governmental and commercial claims, all within a unified system. Benefit from an advanced rules engine that swiftly corrects claims in alignment with the latest regulations from CMS and commercial payers, enabling you to fix any errors before submission. During the claim upload procedure, verify eligibility with all payers and pinpoint any issues that require attention, allowing for essential modifications prior to dispatching the claims. Decrease the days in accounts receivable by utilizing automated workflows to manage audit responses, submit appeals, and oversee administrative dispute resolutions efficiently. Customize staff workflow tasks according to the type of claim and the actions needed for resolution. Moreover, automate the process of submitting secondary claims to avoid the risk of timely filing write-offs. Ultimately, improve your claims revenue through streamlined workflows that support faster and more effective audits and appeals, ensuring your organization remains financially robust. Additionally, the adaptable nature of this comprehensive system allows it to grow alongside your operations, providing sustained advantages over time. This flexibility not only enhances operational efficiency but also prepares your organization for future changes in the healthcare landscape.

Media

Media

Integrations Supported

Inovalon Provider Cloud

Integrations Supported

Inovalon Provider Cloud

API Availability

Has API

API Availability

Has API

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Company Facts

Organization Name

Mack Software

Company Website

www.macksoftware.com/mdoc.html

Company Facts

Organization Name

Inovalon

Date Founded

1998

Company Location

United States

Company Website

www.inovalon.com/products/provider-cloud/revenue-cycle-management/all-payer-revenue-cycle-management/

Categories and Features

Billing and Invoicing

Billing Portal
Contact Database
Contingency Billing
Customer Portal
Customizable Invoices
Dunning Management
Hourly Billing
Invoice History
Mobile Payments
Multi-Currency
Online Invoicing
Online Payments
Payment Processing
Project Billing
Recurring/Subscription Billing
Service Ticket Billing
Tax Calculator

Categories and Features

Insurance Claims Management

CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting

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