Billing and Claims Software for Health & Human Services

MediSked offers software solutions for organizations across the health and human services industry, from providers to government departments to care coordination organizations and payers.

Billing and Payments Kept Simple and Easy for Provider Agencies

Provider agencies use MediSked Connect to manage the billing lifecycle with HIPAA compliant claims submissions and tools. 

MediSked’s billing and claims features allow providers to:

  • Mass-submit claims electronically, make adjustments, and track payments easily. 
  • Utilize prior approvals and authorizations to help with auditing. 
  • Generate and submit electronic claims in a secure 837 format to payers, receive remittance in 835 format to track payments, tools to generate invoices, track claims submissions, and make adjustments.
  • Track and manage budgets easily with tools to review utilization, forecast costs, and review client allocations.
Billing

See Our Billing & Claims Solutions in Action

Increase Speed of Claims Processing for Managed Care Organizations (MCOs)

MediSked’s Care Coordination Suite handles the majority of the financial work for your organization with automatic workflows that save an immense amount of time for staff. Information is sent to payers with very little manual intervention from staff, eliminating errors and increasing efficiency as well as ensuring timely submission of claims.

MediSked’s billing and claims features allow care managers to:

  • Submit, Track, Manage, and Reconcile Claims
  • Manage Billing Exceptions
  • Track and Manage Current and Historical Billing Rates
  • Generate Service Documentation and Audit Review for Billable Activities

How It Works:
HIPAA-Compliant Claims Processing Within the MediSked Care Coordination Suite

The MediSked Care Coordination solution contains functionality that is HIPAA-Compliant for all Claim and Remittance Processing: MediSked Coordinate sends HIPAA 837 claim submissions and receives weekly HIPAA 835 remittance files all coming from the billable services performed and submitted through MediSked Coordinate. The 835 remittance files are then ingested into Coordinate to reconcile all adjudicated claims to display the most current status.

The MediSked Care Coordination calendar is set up to deliver the opportunity to provide either billable or non-billable services. Each task is marked billable or non-billable during scheduling which leads to a claim being submitted to the payer or not.

The claims creation process begins at the task level where the service provider (Care Manager) provides and documents the service for the charges on the claim.  At scheduling, tasks automatically associate with the appropriate service code/tier based on the data linked in the individual’s More Information Page and authorization. Once a task has been completed by a Care Manager it is then sent for audit/approval from the Supervisor or any user with the access to approve/audit tasks.

All potential claims meeting service-specific billable requirements are available for submission to the payer via Submit Monthly Billing Claims. 

 

MediSked monitors submission of files, receipt of acceptance, and processing of responses from payers.  All transactions are catalogued and monitored for any file rejections or transmission errors to ensure accurate billing and payments.