Hospitals

MediGain’s Hospital Division focuses on helping Hospitals Preserve Profits. We understand that greater than 6% of hospital debt goes uncollected each year, nearly as much is written off as charity and overall uncollected medical debt in hospitals has grown by 139% over the past decade. Maintaining adequately staffed back-offices with the latest software packages, electronic claims processing capabilities and expertise in the latest FTC and HIPAA regulations is simply not economically viable for most hospitals. In an understaffed environment, loss of a key employee could have a significant short-term impact on a Hospital’s A/R management and cash flow.

We also understand that Hospitals are facing additional fiscal pressures for the following reasons:

• Escalating Medical Service Costs
• Lower and Increasingly delayed payments from Insurers and Federal Health Insurance Organizations (Medicare/Medicaid)
• Higher percentages of write offs
• Increasing regulatory paper work
• Serving millions of Americans with no coverage as our Country’s Healthcare safety net
• Declining margins since 1997

The MediGain Hospital team focuses on preserving Hospital profits through operational excellence, significantly reduced billing rates (up to 40%), best in class training, the highest levels of certification (CPAM), higher allocation of resources to work claims, and a dedicated account team to ensure premium customer service. This focus led by an experienced team using a sophisticated software package and a three-tiered QA system allows MediGain to process clean claims correctly the first time. Using only electronic processing allows real-time account status monitoring through a password protected website providing daily A/R activity enabling Hospitals more effective management of their business.

MediGain’s Hospital Provider Division focuses on delivery of the following products:

• A/R Management
• Billing Services
• Delinquent Debt Collection
• Insurance Company Claim Management
• Medicare/Medicaid Claim Management
• Eligibility Verification
• Business Process Outsourcing Services
• Bill Coding
• Patient Record Transcription
• Consulting Services including:
• Healthcare Back-Office Staffing
• Upstream Root Cause Analysis
• Compliance Training

All client documentation is saved in our Health Information Portability and Accountability Act (HIPAA) compliant US based data center. Our Operations specialists and HIPAA compliance team have managed these activities at Children’s Hospital in Dallas, TX and developed a three tier QA process and a thorough HIPAA screen over every step in our IS processing.

Please visit our Products and Services page to learn more about our offerings.