Medicare

Features & Benefits

• Direct claims submission to National Government Services (NGS), Mutual of Omaha, Noridian, NHIC, CIGNA and others
  
  
• Extensive edits built into the system, with the ability to add customized edits based on specific needs
  
  
• Special processing (including custom or site-specific edits) is available for:
  
  
• Inpatient claims (Part A, UB04)
• Outpatient claims (Part A and Part B, UB04, CMS 1500)
• Physician billing (CMS1500)
• Skilled nursing facilities
• Home healthcare
• MSP
  
  
• Edits for overlapping claim and 72-hour rule
  
  
• Edit diagnosis for trauma (MSP billing)
  
  
• Edits for Correct Coding Initiative (CCI), required code condition, value code or occurrence code
  
  
• Billed amount, co-insurance, laboratory, net payment, outliers, and other relevant fields

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