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Claims Auditing / Analysis Directory


American Healthnet
2110 S 169th Plaza
Omaha, NE 68130
Email: mpeterson@americanhealthnet.com
Phone: 402-733-2700
www.americanhealthnet.com
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American HealthNet develops integrated enterprise software applications for community healthcare organizations including Hospitals, Nursing Homes, Surgery Centers, Home Health Agencies, Clinics and Medical Laboratories. Headquartered in Omaha, Nebraska, with regional offices in Iowa, Ohio, Oklahoma and Wisconsin, AHN supports over 250 healthcare software installations in the US and Canada. Our focus is on community healthcare facilities that provide a continuum of care across multiple locations requiring fully integrated clinical and business/financial solutions. Our Clarus® native Windows® integrated software suite, with its core Enterprise Master Patient Index, features a full complement of clinical applications--from Order Management to patient EMR--that is fully integrated with the financial applications. Operating in an N-tier environment, access to the system can range from offsite Internet to WAN, LAN and Wireless connections. Users familiar with Windows® applications invariably master our software in record time leading to an extraordinarily smooth and cost-effective installation. All American HealthNet software applications meet HIPAA requirements for EDI, privacy and security.

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APP Design, Inc.
555 Pierce Rd., Ste. 195
Itasca, IL 60143
Email: sales@appdesign.com
Phone: 630-775-1144
www.appdesign.com
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APP Design's extensive healthcare knowledge can help your organization meet its goals. APP's team has worked in the healthcare field for many years, including working on the first community healthcare network the Wisconsin Healthcare Information Network, Western New York HealtheNet , and Healthcare Extranets of New Mexico. In addition to our RHIOnet product for securely linking healthcare information systems, we've also aided organizations with integration projects and HIPAA compliance. APP Design's RHIOnet X12 transaction set helps organizations comply with HIPAA mandated standards. In addition, we can create custom interfaces to existing legacy systems, then use RHIOnet's X12 transaction service to handle incoming X12 transactions, creating "instant" X12 compliance for the organization. Running on top of the APP AnvilT application server, the service supports the following transactions out of the box:

  • 270/271 Health Care Eligibility/Benefit Inquiry and Information Response
  • 276/277 Health Care Claim Status Request and Response
  • 270278 Health Care Services Request for Review and Response
  • 278 Health Care Services Review - Notification
  • 278 Health Care Services Review Inquiry/Response

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BEMAS Software, Inc.
7 The Pines Court, Ste. B
St. Louis, MO 63141
Email: mary@bemassoftware.com
Phone: 314-439-5300
www.bemassoftware.com
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BEMAS Software, Inc. provides employee benefit management software that allows you to purchase the specific programs you need to manage your benefits plan. The PayDirect product line is a suite of software solutions designed around modules giving you the ability to purchase just what you need, when you need it. PayDirect software modules are used by TPAs, insurance companies and self-insured companies.

With PayDirect you can improve your company's profitability by reducing your administrative costs in automating the time consuming, mundane, day-to-day claims and plan administration activities. PayDirect software is designed to be used right out of the box and is flexible enough to be easily customized to meet your specific needs. You can customize and integrate all of PayDirect software solutions as your needs change and grow.

The PayDirect product line includes: Insurance, HighD 105, Billing, 125, Dental Insurance, Dental DR, Debit Card, Web, Scheduler and InfoDirect edi. Visit www.bemassoftware.com for in-depth descriptions for each product and to request a demo.

Choosing the PayDirect product that is right for you is easy! Start by deciding which base PayDirect software product (Insurance, HighD 105, Billing, 125) you may be interested in and ask for a free Demo CD. Add on any additional integrated modules and you will have a benefit administration management system tailored to your company's specific needs. Call today to see how BEMAS can simplify your benefit management program.

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CollaborateMD
201 E. Pine St., Ste. 1310
Orlando, FL 32801
Email: sales@collaboratemd.com
Phone: 888-348-8457
www.CollaborateMD.com
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Headquartered in Orlando, FL, CollaborateMD is a leading provider of Internet medical billing and practice management software for physician offices and medical billing services. Our software provides the health care industry with a HIPAA-compliant Revenue Cycle Management application that has the speed of a local PC application and the "use anywhere" flexibility of a Web browser application. CollaborateMD is a 100% Java application utilizing Sun Microsystems Java Platform.

CollaborateMD offers more than 3,000 medical providers across all 50 states the opportunity to become more efficient and flexible. Users of our software have the power and flexibility they need to immediately increase office productivity, which allows physicians and hospitalists to spend more time focusing on the patient. From appointment scheduling and record-keeping to claim tracking and validation, CollaborateMD offers a full-service solution to meet your unique needs. What's more, our Internet-based system provides quick, ready-to-use, and fully customizable reporting capabilities. Our system is so easy to install; your office will be up and running in hours instead of weeks.

For more information, visit CollaborateMD.com or call 888-348-8457.

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CureMD Corp.
55 Broad St., 9th Floor
New York, NY 10004
Email: info@curemd.com
Phone: 212-509-6200 Ext. 236
www.curemd.com
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CureMD PRS (Practice Resource System) is a comprehensive network of integrated systems and services, designed to address every aspect of a medical practice's clinical, financial and administrative workflow. A true Web-based solution, CureMD PRS is available in either of two ways:

ASP (Application Service Provider): A monthly subscription-based service, securely accessible over the Internet

Client Web-server: A locally hosted client-server through which clients have the option of publishing on the Web for secure and remote access from any Internet connection

  • Intelligent Billing and Reporting
  • Enterprise Scheduling
  • Electronic Health Records
  • Mobile/handheld charge capture
  • Prescriptions Management
  • HIPAA Compliance

With CureMD EHR (Electronic Health Records), the age of practical, affordable EHR has finally arrived. Our efficient, cost-effective and fully integrated approach to EHR puts clinical information management easily within the reach of virtually any practice, solving the multiple problems of storage and retrieval of patient records and making point-of-care decision support and order entry an instant reality.

Customizable templates and SOAP-format architecture are easily adapted to any specialty. At the same time, built-in clinical decision support and CPOE features minimize pharmacy callbacks and duplicate prescription and lab orders, reduces risk of errors, and improves documentation quality and compliance.

Templates -- easy-to-use, customizable drop-downs and check lists make it simple to accurately document:

  • Vitals
  • Phone Encounters
  • Histories
  • Medications
  • Review of Systems
  • Immunizations
  • Physical Exams
  • Orders (medications, labs, procedures)

Contact us today for a demonstration of CureMD or visit our website

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Dimensional Insight, Inc.
111 South Bedford St.
Burlington, MA 01803
Email: info@hospitalanalysis.com
Phone: 866-204-8984
www.hospitalanalysis.com/HITYP/
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Established in 1989, Dimensional Insight is a business intelligence solution provider specializing in the development and marketing of multidimensional data visualization, analysis, and reporting software. The Diver Solution enables decision makers across all levels and functional areas of a healthcare organization to access and analyze data from disparate sources quickly and intuitively.

The Diver Solution for healthcare providers allows "Divers" to analyze financial, clinical, operations and human resources data. Hospital systems, facilities, physician groups, and clinics are able to integrate and access information without requiring IT assistance. This powerful solution enables healthcare executives to ensure patient satisfaction and nursing productivity, while tracking patient flow, performing reimbursement analysis, and analyzing disease trending. Hospital organizations also use The Diver Solution for physician scorecarding, JCAHO reporting, executive dashboards, EMR reporting and ad-hoc analytics.

Our powerful web-based approach empowers users to access, analyze, and create reports from information that is customized to their individual needs. Healthcare organizations can integrate various source systems including, (but not limited to) 3M Health Information Systems, Cerner, CliniComp, Eclipsys Sunrise Decision Support (TSI), Kronos, McKesson (HBOC) Trendstar and Information Systems, MEDITECH, Oracle, and many others.

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Easy Business Software
3632 Land O' Lakes Blvd., Ste. 101
Land O' Lakes, FL 34639
Email: sales@x-link.info
Phone: 800-645-2962
www.ezbizware.com

Easy Business Software was formed in March of 1988, and is now celebrating "17 Years of Excellence." Easy Business Software takes its roots from computer hardware, computer software and consulting businesses. Our founders have been actively involved in the software business for over 40 years and brought this experience together to make Easy Business Software a highly successful business. The staff and management of Easy Business Software look forward to a future of continued success, providing customers with stable, workable software products and the highest level of customer support for these products.

Easy Business Software is a consultative technology integrator and software developer focused on delivering solutions to the physician market for improving patient care. Easy Business Software manufactures X-Link, the industry standard for integrating disparate clinical and practice management systems and services. This industry standard integration product provides seamless integration for over two thirds of the practice management systems used in the one to three physician market.

Easy Business Software has attained the distinguished level of NDC Health Platinum Certified Reseller consistently since 1996 and has also consistently been awarded NDC Health's President's Achievement Club since the club's inception in 1997.

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Eldorado Computing, Inc.
5353 North 16th St., Ste. 400
Phoenix, AZ 85016
Email: abell@eldocomp.com
Phone: 602-604-3100
www.eldocomp.com
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Eldorado Computing Inc. is a leading supplier of IT administration solutions for healthcare organizations, self-funded employers, third party administrators, insurance carriers, independent physician associations, and unions. Eldorado's software is available on an ASP hosted or licensed basis. Eldorado provides a leading edge proven solution for automatic claims processing of medical, dental, vision, prescription drug, long-term and short-term disability claims.

Eldorado's HEALTHpac is the foundation for claims repricing, managed care functionality, billing and administrative functions, case management, utilization review, PPO management, COBRA management, Section 125 administration, batch laser printing, electronic claims transmissions, ad hoc reporting and claims edit processing. Other products include: Imaging, Workflow, X12 Manager (HIPAA), Customer Service Interface, and real-time employee self service web applications.

Founded in 1981, the privately held company is based in Phoenix, Arizona, and has affiliate offices in Barberton, Ohio. For more information about Eldorado, visit the company's Web site at www.eldocomp.com or call (602) 604-3100.

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ExaMedIT, Inc.
1675 Larimer St., Ste. 410
Denver, CO 80202
Email: stephen.hammond@examedit.com
Phone: 800-824-1233 Ext. 340
www.examedit.com

ExaMedIT is an Internet based service company that offers to multi-specialty group practices, billing services, claims clearinghouses, and the insurance industry electronic claims editing and on-line billing while concurrently maintaining quality control and efficiency between the providers and payers.

Providers and payers are looking for methods to reduce costs while maintaining a system of quality control checks. ClaimCorrect is a dynamic web based application that uses a sophisticated and extensive database to analyze claims relative to the rules established by third party payers. Upon review, ClaimCorrect will pass any errors detected to the provider for examination and correction, which will help generate "clean" claims for accurate submission and subsequent reimbursement.

Although there are many available tools to help practices code correctly and comply with the National Correct Coding Initiative, ClaimCorrect is unique in its ability to thoroughly review the data contained within the claims submission process. This review is in accordance with the individual payer's "rules" and performed entirely in the background.

MedBillCorrect is an online medical billing application that provides medical practices with cost effective access to a state of the art relational database practice management solution suite that includes billing/claims and compliance monitoring.

ClaimCorrect and BillCorrect products are based on the ASP model and are both HIPAA compliant applications. Service operations take place at a secure, central center. Users access the system through standard Internet browser software. Unlike other so-called ASP systems, no other software is required to operate the system.

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First Consulting Group
111 West Ocean Blvd., Ste. 400
Long Beach, CA 90802
Email: fcgmarketing@fcg.com
Phone: 800-345-0957
www.fcg.com
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First Consulting Group (FCG) is a leading provider of outsourcing, consulting, systems implementation and integration for healthcare, pharmaceutical, and other life sciences organizations throughout North America, Europe and Asia. Through combinations of on-site, off-site and offshore resources, FCG provides low-cost, high-quality services to improve its clients' performance. The firm's consulting and integration services increase clients' operations effectiveness with information technology, resulting in reduced costs, improved customer service, enhanced quality of patient care, and more rapid introduction of new pharmaceutical compounds. For more information about FCG, visit www.fcg.com or call 800-345-0957.

The FCG Difference:

  • Client-centered approach -- We place our clients' interests first because we know that we cannot succeed unless we do. Our approach to every project is to drive for client success and satisfaction above all.
  • Healthcare expertise -- Our associates are technology experts as well as physicians and nurse practitioners who bring real-world knowledge to every project. With an average 15 years of experience, our associates understand the challenges that you face and have the expertise to formulate solutions that leverage technology to meet your business needs.
  • Proven methodology -- FCG's ContinuumTM framework, built upon the significant experiences of our healthcare professionals, is a robust set of comprehensive tools, processes and industry best practices that help clients achieve tangible benefits in an accelerated fashion. Continuum's tools and methods offer flexibility and predictability, encourage knowledge transfer, and integrate with key software vendor products. Continuum provides the road map to true clinical and operational improvement.
  • Proven Track Record -- Our reputation in the industries we serve speaks for itself. FCG is the choice of the leaders in healthcare and life sciences, whom we have helped to solve the most complex problems and achieve the most challenging strategic goals.
  • Thought Leadership -- FCG is deeply committed to positively impacting the industries we serve and to leaving a positive, lasting impact on our clients' performance. FCG's thought leaders bring years of experience and perspective to our vision of improving the performance of the industry and our clients. Our thought leadership is incorporated into our projects and helps us deliver innovative and leading-edge thinking on how to best apply technology to business challenges. FCG also provides research and program advisory support for the Scottsdale Institute, a unique learning forum that assembles senior leadership from major delivery systems to address the relationships between strategy, operations and information management.

For more information, please visit our website www.fcg.com

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Mardon International Healthcare Services
4111 E. Valley Auto Dr., Ste. 210
Mesa, AZ 85206
Email: info@mardonihs.com
Phone: 800-877-9257
www.mardonihs.com
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A leading software vendor in the health care informatics industry for 27 years, Mardon IHS provides integrated software solutions that meet the information needs of health care organizations worldwide. The organizations we serve include hospitals, ambulatory care centers, long term care and behavioral health facilities, home health organizations and physician practices.

We accomplish results and efficiencies other vendors don't, at a value they can't match, because of the functionality and the integration designed into our systems. Our systems cover all facets of the health care spectrum, from primary care to continuing care management. Information is integrated both horizontally across care facilities and vertically among the physicians orchestrating care, the nurses delivering care, and the clinical departments supporting this care. Clinical and financial information is fully integrated tightly coupled so health care organizations operate efficiently.

Our platform is designed and engineered with an understanding of the reliability critical to Health Care Information Systems, and the flexibility essential for information systems to continually evolve to meet changing health care dynamics.

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Medical Present Value, Inc.(MPV)
5000 Plaza on the Lake, Suite 265
Austin, TX 78746
Email: info@mpv.com
Phone: 512-795-0015
www.mpv.com
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Medical Present Value, Inc. (MPV) provides financial tools and expert consultative services to help physician medical groups maximize the value of their payor contracts and improve revenue cycle efficiency.

Our expert contract analysts define and model the complex terms of each contract line-by-line into the MPV PhynanceTM software solution. MPV also maintains a database of client-specific contract terms, fee schedules and payment policies and continually updates Medicare, state and other payment rules to ensure claim pricing is accurate.

MPV Phynance then values claims and identifies variances by comparing payments received against contract terms, flagging potential underpayments, registration, coding and posting errors. The contract data and claims history stored in MPV Phynance can then be used to assess overall payor performance and determine the financial implications of new and proposed contracts during future negotiations with payors.

As a result, our physician medical group clients experience better control over their contracts, improved workflow efficiency, increased revenue, reduced bad debt and stronger negotiating position with payors.

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MedInformatix
5777 W. Century Blvd., Ste. 1700
Los Angeles, CA 90045
Email: sales@medinformatix.com
Phone: 310-348-7367
www.medinformatix.com

MedInformatix is a leader in integrated EMR and practice management systems. We have 900 installations throughout North America and seek distribution partners in all specialties.

MedInformatix Radiology Information System is the one-stop, turn key solution for today's radiology practices. Its ability to interface to your choice of PACS and its fully integrated billing/collection modules with the state of the art web-referring module truly sets MedInformatix RIS apart from all its competitors.

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Perceptive Software, Inc.
22701 West 68th Terrace
Shawnee, KS 66226
Email: info@imagenow.com
Phone: 800-941-7460
www.imagenow.com
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Perceptive Software's mission is to create a direct and effortless connection between business workers and the documents they need to complete their daily activities. Our flagship product, ImageNow, lets users efficiently capture and organize virtually any document type, then retrieve a precise page with a single click from within any business application at the moment it's needed.

Since its beginnings in 1988, Perceptive Software has continued to innovate the delivery of document management software that is cost-effective without sacrificing functionality. The key is patented integration that weaves ImageNow tightly into any business software application, regardless of manufacturer or platform, without need for a single line of code. Every ImageNow installation offers customers the security, speed and anytime, anywhere access to documents that are critical in today's competitive global business environment.

With ImageNow, key data from captured documents is automatically extracted and indexed to create a link to the appropriate existing record. Now workers have a way to organize all related documents, retrieve and view any one with a single click and route them electronically for additional action or approval.

Perceptive Software's distinct business model helps customers across all industries build on existing infrastructure and hardware investments, with no long-term maintenance costs. From large, multi-site corporations to small businesses and everyone in between, customers use ImageNow to reclaim time, money and their sanity at the department level and organizationwide. Our philosophy is to educate users early-on, equipping them with the right mix of tools and support to help them truly make ImageNow their own.

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Sajix, Inc.
990 Laguna Creek Lane
Pleasanton, CA 94566
Email: info@sajix.com
Phone: 925-218-7370
www.sajix.com

Sajix is a leading provider of healthcare information system solutions, serving both the needs of healthcare providers and consumers. Our comprehensive suite of HIPAA-compliant solutions, called iHelix, is comprised of individual, but integrated modules including an advanced electronic health record (EHR) which enables our clients to build a customized health information system that meets their specific needs.

Sajix iHelix software solutions are completely scalable and can handle the IT requirements of community-sized hospitals as well as large, urban-based medical centers. We also offer our solutions on the technology platform that best suits our clients' needs. For large enterprise deployments we offer iHelix Enterprise, a scalable, comprehensive, in-house, server-based solution. For community-sized hospitals, we offer iHelix OnDemand, a hosted solution that is perfect for meeting the needs of small to medium sized facilities who prefer a hosted solution.

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Spectron Corporation
5416 S. Yale, Ste. 650
Tulsa, OK 74135
Email: charles.young@spectronco.com
Phone: 918-488-8031 Ext. 3117
www.spectronco.com
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Spectron Corporation has been a Healthcare Information System Outsourcing and Consulting company for 34 years. It is engaged in the analysis of hospital information system processes and the sale, implementation and ongoing support of complete hospital information systems. Spectron consulting service professionals' are available to study, report on and improve the hospital's information process flow as it relates to cash flow, quality of patient care delivery, labor utilization and turnover, material costs and community impact. Spectron has been a McKesson reseller of the S2000 HIS software since 1983 and is experienced in the implementation and support of this and other HIS systems.

In addition, Spectron Corporation has developed and supports its own service process optimization software, designated ERSS. ERSS overarches and front ends existing HIS systems and is designed to maximize the use of hospital human and capital resources driving highest revenue out of existing assets. Spectron supports and maintains the associated PC networks, servers, local area networks and wide area telecommunication networks used to run these applications. Many of the hospitals are linked on virtual private networks utilizing servers located in Spectron's data center.

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XIMIS, Inc.
6006 N. Mesa, Ste. 902
El Paso, TX 79912
Email: jinakim@ximis.com
Phone: 915-832-0134
www.ximis.com
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XIMIS, extended International Management Information Systems, is a growing medical information technology company focused on providing clients with a wide range of high-caliber and customized technology solutions. The products that we offer and develop are as unique as the people who make up our company.

We specialize in medical applications like XIRIS, eXtended Internet Radiology Information System. XIRIS is a completely web-based application designed to manage patient registration, scheduling, exam tracking, staff and resource management, and the generation of reports and statistical information.

Through a variety of state-of-the art modules, your Radiology Center will have a complete solution for information management in the 21st Century. XIRIS improves workflow and productivity through the use of electronic medical charts and a variety of tracking tools. XIRIS provides HIPAA compliant auditing logs and enhanced security levels to protect patient data as well as having a fully integrated Billing System.

XIRIS can easily be integrated into a new or existing center via its HL7 Broker or DICOM Worklist Manager. It will also share information across multiple centers with XIRIS RIS-Backbone available in a variety of formats to fit your multi-center model.

XIRIS is completely modular so that your center only implements the features and functionality it needs. Your partners at XIMIS, Inc. are ready and able to assist you in devising practical and innovative solutions to the information and decision-making challenges that you face in a world of growing technical complexity and finite resources.

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Who is in this category?

American Healthnet
APP Design, Inc.
BEMAS Software, Inc.
CollaborateMD
CureMD Corp.
Dimensional Insight, Inc.
Easy Business Software
Eldorado Computing, Inc.
ExaMedIT, Inc.
First Consulting Group
Mardon International Healthcare Services
Medical Present Value, Inc.(MPV)
MedInformatix
Perceptive Software, Inc.
Sajix, Inc.
Spectron Corporation
XIMIS, Inc.


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