ImagineMedMC

Managed Care Software Solution

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A comprehensive and automated claims processing system for managed care organizations

MedMC


ImagineMedMC™ is a "start to finish" healthcare delivery system that allows you to manage healthcare costs and quality of care including eligibility, referral and authorization processing, provider contracting, flexible pricing methodologies, benefit administration, auto claims adjudication, capitation (PCP and Specialty), EOB/EFT check processing, and EDI transfers and reporting.
ImagineMedMC™ can be deployed as a cloud solution or an in-house system and is ideal for the following types of organizations:
  • Managed Care Organizations (MCOs)
  • Independent Physician (or Practice) Organizations (IPAs)
  • Third Party Administrators (TPAs)
  • Preferred Provider Organizations (PPOs)
  • Self-Insured Groups
  • Insurance companies and companies administering specialty products and services for mental health, home health, lab, physical therapy, etc.

Did you know?

Regardless of the complexities around submitting claims and the labor associated with managing denials, 31% of providers are still using manual claims management processes. Manual processes can slow down productivity, given the amount of data needed to manage claims at a successful rate.

"A lot of companies say that their software can do great things, but that’s not always the case. MedMC can actually do the things that ImagineSoftware says it can do. Our auto-adjudication rate has really improved. We save a lot of time getting payments out to providers and they’re much more accurate. That’s the most important thing for us."

— Marissa Massey, Director of Information Systems, Physician’s DataTrust
Read more about Physician's DataTrust's experience with MedMC

Benefits of ImagineMedMC™


User-friendly and available in Green Screen or GUI


Claims are auto adjudicated


Client-specific customization


Comprehensive claims pricing methodology


Multiple selection criteria for capitation processing


HIPAA compliance formats

Maximize Productivity

  • Member eligibility and benefit history
  • Referral management and fax referral authorization
  • EOBs and check writing
  • Provider contract management
  • Letter writing templates
  • Premium billing
  • Reporting and data warehousing

Seamlessly integrate the complexities of administrating eligibility, referral authorization and claims processing. MedMC functions and features maximize data integrity while reducing data entry.

"I know the MedMC team well. They will do whatever it takes to get things done. We often receive last minute requests with things our business leaders want changed quickly. Also, sometimes our clients are unclear about our prioritization and requirements, and that can change at the drop of a dime. That being said, the MedMC team will always pick up the phone when we need them."

— Leo Pelletier, Systems Application Manager, Steward Health Choice
Read more about Steward Health Choice’s experience with MedMC

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