Manage Appeals Directly in the PDR Module
Resolve provider disputes faster with a dedicated appeal workflow in the PDR module that lets you classify issues as appeals, generate health plan letters, and close cases without creating claims.
Automate ACO File Imports with Smart Scheduling
Save time and eliminate errors with automated file pickups from a secure SFTP location—complete with built-in checks that validate file type, format, and frequency before loading.
Apply MIPS-Based Adjustment in Medicare Pricing
Streamline performance-based reimbursements by enabling default MIPS adjustments in Medicare pricing, keeping payments aligned with CMS quality programs.
Calculate SNF Contract Amounts with FinThrive Logic
Use prior claims from the same admission to accurately calculate bundled SNF pricing, ensuring fair reimbursement and reducing the need for manual adjustments.
Enable ZIP Code-Based Rates for DME Home Services
Improve DME claim accuracy with automated pricing logic that uses the member’s ZIP code when care is delivered at home, ensuring compliant, location-specific reimbursement.
Identify Claim Edits with PCG’s VEWS
Leverage QuickCap’s integration with PCG’s Virtual Examiner (VEWS) to automatically scrub claims for errors before processing. Review line and header level edits, apply payer-specific rules to reduce rework while improving claim accuracy.
New Automation
QuickCap now automates file pickup from a secure SFTP location, utilizing smart validation checks by file type and frequency. Once retrieved, the system instantly displays the files in the ACO Files Load pane, saving time and ensuring accurate data loads.
Improved Experience
Reduce the back-and-forth in clinical reviews by using the new Regimen button for P-type codes to enter dosage, frequency, and treatment details in one place.
Precision
By default, QuickCap now applies MIPS-based adjustments in Standard Medicare Pricing to support more accurate, performance-based reimbursement. Easily manage this setting in the Line of Business Code pane and track the changes using the Audit Log symbol.
Enjoy greater accuracy and efficiency in SNF claims processing with FinThrive’s enhanced pricing logic, which now calculates contract amounts using prior claims from the same admission date. Easily review grouped claim details, such as service dates, total charges, and billing codes, and quickly identify non-per diem invoice types with the new NDG pend code.
The Medicare fee schedule workflow now includes support for Contractor Status Code rates from MAC Novitas, in addition to Noridian. Labels in the Standard and Extended Fee Schedule submodules have been updated to reflect support for MAC Jurisdictions E, F, H, and L.
Efficiency
Use the new Claim Freq. drop-down and Original Ref.# box in the CMS1500 - Scanned Claims and CMS 1500 - Text File submodules to send corrected claims with greater speed and accuracy.
New Automation
Automatically scrub claims before processing using PCG’s Virtual Examiner (VEWS) integration. Review header and line level edits, apply payer-specific rules, and improve claim accuracy with less rework.
Efficiency
Easily manage provider disputes with a centralized PDR submodule designed for faster updates, smarter status controls, and full system integration. Configure when claims are created or skipped, and tailor workflows to better support appeals and resolution timing across your organization.
New Automation
Enhance DME claim accuracy with smarter pricing automation. When the place of service (POS) is 12 – HOME, the system automatically uses the member’s ZIP code for Medicare pricing, ensuring accurate reimbursement for home-based services.
New Automation
Automate and batch-send letters to health plans with the new Health Plan automation option in the Template Mapping submodule. Streamline dispatch settings and improve tracking across your PDR workflow.
Efficiency
Use the new Claim Freq. drop-down and Original Ref.# box in the CMS1500 - Scanned Claims and CMS 1500 - Text File submodules to send corrected claims with greater speed and accuracy.
New Automation
You can now generate ACH prenote files to verify bank account details before processing payments. This added feature helps ensure payment accuracy and reduces the risk of rejected or failed transfers.
Custom Configuration
Give your providers more control over how they get paid. External users can now register and manage multiple electronic funds transfer (EFT) accounts for claims payment processing, making it easier to route payments by location, entity, or preference.
SOC Certification Achievement
MedVision has successfully met the criteria outlined in the SOC (System and Organization Controls) audit for service organizations. This certification demonstrates MedVision’s adherence to rigorous standards for security, availability, processing integrity, confidentiality, and privacy.
As a service provider managing sensitive data and overseeing critical functions on behalf of clients, this certification underscores MedVision’s commitment to maintaining high standards of operational excellence and data security.
HITRUST Risk-Based 2-Year Certification Achiever
The Health Information Trust (HITRUST) is a standards organization dedicated to security, privacy, and risk management. They developed the HITRUST Common Security Framework (CSF), which assists organizations in maintaining a comprehensive and secure approach to HIPAA compliance and managing risks. HITRUST is widely recognized as the benchmark in data security and privacy.
Certified Member of HCAA
The Health Care Administrators Association is the nation's largest nonprofit trade association for third-party administrators, stop loss insurance carriers, managing general underwriters, audit firms, medical managers, technology organizations, pharmacy benefit managers, brokers/agents, human resource managers, and health care consultants. HCAA has spearheaded the change of self-funding for more than 35 years.
Awarded by CIO Review
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MedVision was featured as one of the most promising healthcare solutions providers.
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