Revenue Cycle

The Revenue Cycle solutions helps your organization to manage patient billing efficiently, from the issuing of referrals to the generation of bills and collection. As a result, you are able to gain timely reimbursement for services rendered. The following capabilities are included:

• Capture, Storage, and Retrieval of Patient Charge Information

• On-line Account Inquiries with a Real-time Update of Patient Demographic Data

• Bills, Statements, Claim Forms, and Logs

• Receipts, Adjustments, and Refunds

• Autoproration Capabilities

• Account Follow-up and Management Reports.

For more specific functionality details, view the functionality brief.

MEDITECH's Revenue Cycle solution includes a Balance Forward conversion, a Comments conversion, and Electronic Claims Submission/Remittance (eClaims) interfaces. EClaims may include a maximum of 12 Submission and/or Remittance interfaces, regardless of payor.

All payors must follow the electronic 837 Claim Submission and electronic 835 Claim Remittance compliancy requirements (enacted in 2002). MEDITECH handles a variety of communication protocols and file formats in order to send submissions and receive remittances from other systems or intermediaries. The specifications for this interface should be determined by the Electronic Media Claims (EMC) specifications from your intermediary.

In the U.S. interfaces typically include: Blue Cross Institutional, Blue Cross Professional, Medicaid Institutional, Medicaid Professional, Medicare Institutional, and Medicare Professional claims. In Canada, the interfaces typically include: In-Province, Out-of-Province, and Provincial Workman's Compensation Institutional claims.

MEDITECH will provide replacement of other insurance-related electronic or tape format submissions or remittances in prior use in the customer's live environment as of the date a new license agreement is executed for the Revenue Cycle solution.