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Hosting Services – SaaS
MDHost has combined its 12 years as a hosting service and technology company to bring……….. read more



Electronic Health Records Network
The Electronic Health Records Network [EHRN] allows users to gain access to medical information, claims processing, scheduling and reporting through a secure HIPAA compliant network from any Internet location……….. read more

Electronic Medical Records
MDHost has combined its 12 years as a hosting service and Technology Company to bring a web based hosting service to………..read more

Patient Health Records
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Electronic Claims and Denials Management

Claims denial management can enhance revenue in times of declining payment and increasing cost pressures. Denials usually arise from process problems leading to inadequate documentation. MDHost’s denial management team oversee prospective prevention and claims recovery. Prospective prevention minimizes denials by defining scope of service, tracking causes for denials, and improving related processes. Claims recovery improves chances of recovering denied payment. MDHost has instituted best practice processes that are aimed at preventing denials by “scrubbing” claims prior to submission. Our best practice reporting and trending plays a key role to developing internal practice processes to avoid future denials All charges are scrubbed using MDHost’s “Scrub Manager:” to assist in optimizing claims and avoid rejections and denials. The claim is compared against a sophisticated database of standards that contain millions of edits designed to avoid health plan rejection and denial. “Scrub Manager” verifies modifier usage, checks for CCI bundling edits (CMS' National Correct Coding Initiative), determines code validity, displays Relative Value Units (RVU), validates pass-through items, and verifies medical necessity. “Scrub Manager” will notify at entry any charges that are inconsistent with the current Medicare coverage guidelines. Management statistics can be obtained from a data warehouse that stores information from Electronic Explanation of Benefits [EOB] reports and Electronic Remittance Advices [ERA] manually posted EOBs, and unsolicited claim status data like U277 notifications or text-readable reports. In addition, these monthly reports are available:

• First Pass Clearinghouse: Percentage of claims that are accepted upon initial submission.
• Total Rejects: The total number of rejections and their dollar value.
• Top Reject Categories: The most common reject categories.
• Total Denials: Total number of denials and their dollar value.
• Top 10 Denial Categories: The 10 most common denial categories.
• Top 10 Denial Categories Excluding Contractual Adjustment: The 10 most common denial categories excluding CA.
• Denial Group Comparison Report: A comparison of denials based on the HIPAA group code determination.
• Denials Related to Front Office: The total number of denials and the percent related to front office functions.
• Denials Related to Coding: The total number of denials and the percent related to improper diagnosis and procedure codes.
• Denials Related to Timely Filing: The total number of denials and the percent related to timely filing.
• Reworked Claims: Payer-rejected claims that were resubmitted.
• Transaction Summary: Overview of transactions and counts.
• Adjustments Summary: Summary table of all claim adjustments for all payers.
• Patient Responsibility by Payer: Summary table of percentage patient responsibility.