Medilexis solutions and services ensures fast and easy recovery of payments which eventually results in better practice management and revenue increase of almost 25%.

There is no capital investment involved. No expenses on hardware and software. This system completely eliminates the strenuous process of training existing staff. Medilexis provides absolutely free software with only location fee and user license. You pay as you use.

Coding:
Medilexis specializes in Medical Coding Services to healthcare providers. Our experienced coding consultants will provide your organization with the highest level of quality medical coding services available. You will receive accurate and complete coding that is fully compliant with all of the Correct Coding Initiatives and Local Medical Review Policies. Using Medilexis' services will ensure that you are receiving all of the reimbursement to which you are entitled while improving your organizations compliance objectives.
Do you realize that approximately one forth of all medical practice income is lost due to under coding and wrong coding? Hundreds of millions of dollars are lost annually due to medical coding errors.

• Are coding errors wasting your resources, time and money?
  
• Are you facing a shortage of trained and experienced coders?
  
• Are high labor costs and high turnover draining your resources?

Our medical coding services enable individuals and hospitals to reduce labor costs, improve accuracy through our high quality operations.

Our coders are highly professional and skilled in international coding practice with:

• CPT, ICD-9- CM, HCPCS coding across various specialties
  
• Insurance and government regulatory requirements<
  
• Payer specific coding requirements

Coding Process:

• Coding of the diagnosis and procedures with reference to ICD, CPT and HCPCS.
• Checking the compatibility of the diagnosis with the procedure codes.
• Checking for the modifiers in relation to the procedures.
• Sending files for QC (Quality Control)
• The quality control rechecks the complete coding with all the references available.
  
• In case of any confusion, a problem list is sent to the practice/hospital for clarification.

Billing:

Billing interface to the insurance carriers is seamless. Eligibility, submission and follow-ups are continuous and done electronically. Medilexis is a leader in electronic medical billing and insurance claims processing services for the healthcare and insurance industry. We offer professional services at competitive rates. Our unique outsourcing model offers a highly cost-effective and reliable solution to the medical billing service providers targeting higher growth rates, larger capacities and better return on investments (ROI)

We process claims for all healthcare agencies that use the HCFA 1500 form, and dental practices that use the standard American Dental Association form and can also process hospital out-patient UB-92 forms.

• Electronic claims submission
  
• HCFA forms processing
• Patient information and charge entries
• CPT, ICD- 9 and HCPCS coding
  
• Online Web based Customized Management Information Reports
  
• Scheduling
  
• Information coordination
  
• Patient demographics/insurance entry
  
• Code checking and analysis
  
• Posting of charges
  
• Claims submission (electronically & manually)
  
• Posting of payments-EOBs
  
• Sending patient statements
  
• Follow up (Third Party, Patient & Provider) Comprehensive reporting & analysis

Imagine eliminating those costly interruptions - the biller called in sick, paying for sick leave, training new employees, figuring out what happened to your claim, etc. Leave the headaches of bill processing to us! We operate 6 days a week. You will never have to worry about your claims not being processed and followed up on a timely basis.

Medical Practice Benefits

• More time to provide superior health care services.
  
• More time for treatment plans and necessary paperwork pertaining to patients.
  
• More time to develop in-house marketing efforts.

Expedite Cash Flow

• Insurance payments in 7 to 14 days.
  
• Up to 50% faster reimbursement compared to mailed claims.
  
• Claim submission error reduction.
  
• Secure online bill tracking.
  
• Increased percentage of collected claims, fewer rejected claims.
  
• Challenge of all rejected claims.
  
• Reduction of medical practice overhead.
  
• Free consultation.
  
• Analysis reports to assist your Practice Management.

Medilexis specializes in claims consulting to healthcare providers. Our experienced claims consultants will carefully assess every detail of your claim and the insurance carrier's denial in an attempt to determine the most appropriate and effective action to be taken on accounts placed with us. Further, we will research the most recent case and statutory laws, which support payment on your insurance claims.

Overview:
We do pre-collections follow up for claims which have "reject/resubmit" status and have aged beyond 60 - 90 days and are not ready to be assigned to collections. We believe that there is significant value in pursuing these types of claims on behalf of your healthcare facility, particularly in the wake of resource limitations that can prohibit your facility from processing these claims with the same timeliness as the newer claims.
In spite of timely payment rules in many states, a common complaint of all hospitals is difficulty in collecting accounts, which are 60 to 90 days old. Many hospitals have a difficult time reprocessing such claims.

Our goal is to lessen the burden of un-collectible accounts on your facility's financial health.

Benefits:

• An alternative to immediate collection agency placement
  
• We successfully secure full benefits of claims previously denied
  
• Provider can maintain good patient/provider relations
  
• Overall improvement of financial performance, cash flow and profitability

Solution:

Collection of these accounts typically requires:

• Submission of medical or operative records
  
• Patient completion of coordination of benefits or other forms
  
• Correction of improper billing information
  
• Re-submission to the proper carrier

Two-pronged strategy would be adopted:

• To gather denial/rejections details, reasons, etc through follow ups
  
• To take appropriate actions, i.e. re-filing of claims, etc

1. Follow Ups:
We track denials, log what has been denied, why, how, and when the claim was filed to the greater levels of details.

Keeping in view electronic transactions standards (276/2777) of HIPAA, we will get to the bottom of the claims status, & then will hit the claims accordingly which may include knowing:

• Pre-adjudication (accepted/rejected claim status)
• Claim pended for development (incorrect/incomplete claim(s) within adjudication process) or suspended claim(s) requesting additional information
• Finalized claims. Further defined, finalized claims may have outcomes that include finalized rejected claim(s), finalized denied claim(s), etc.

It should be kept in mind that denials out of medical necessity (mis-coding of claims) will be easy to handle and collect. The denials due to timely filing and incorrect or incomplete information can turn out to be more problematic, especially for claims of a year old or more.

2. Re-filing of Claims:
Reviewing of the reasons for denial, making necessary changes and resubmitting the bills.

As a full service provider offering Imaging and OCR conversion, we have performed many large and smaller projects requiring OCR conversion. We currently have a number of OCR/ICR software (professional versions) capable of performing conversion on projects of different requirements.

We are currently providing services to clients, both large and small organizations. That number however changes from one day to another since some clients are one-time only (backfile conversions) while others are on-going.
We also provide healthcare claim data capture. It is currently handled in our offshore facility.

Over a number of years, we have managed extensive data, text and image conversion projects for Government Ministries and Departments and a wide range of Fortune 500 Canadian and U.S. organizations. These organizations are within the financial services, publishing houses, insurance industries, healthcare and the communication sectors, among others. The types of projects have included full text conversion, credit card applications processing, general ledger conversions and government contracts among others. Additionally, for a number of firms, we are under contract to provide ongoing daily data entry services as well as to supplement their in-house data entry staff.

Capabilities:
Turnaround times vary from project to project, from same-day to 24 hours to weekly. Turnaround is contractually guaranteed with each client and is an important factor in our service level procedures.

We guarantee an accuracy level of 99.8% to all our clients or the work is redone at no cost to the client. We are proud to say that we have never missed this commitment. Accuracy levels are achieved by several techniques such as double, blind data entry, quality checking of data before being returned to the client and strict adherence to requirements.