Start-to-Finish Healthcare Delivery System

Includes eligibility, referral and authorization processing, provider contracting, benefit administration, auto claims adjudication, capitation (PCP and Specialty), EOB/EFT check processing, and EDI transfers and reporting.

Flexible Deployment Options

Deploy as a cloud solution or an in-house system. Ideal for managed care organizations (MCOs), independent physician organizations (IPAs), third-party administrators (TPAs), preferred provider organizations (PPOs), and self-insured groups.

Maximize Productivity

Streamline the complexities of administrating eligibility, referral authorization and claims processing. Features and functions maximize data integrity while reducing data entry.

Features of ImagineMedMC™
  • Claims Pricing Options

    Percentage of charges, per diem, DRGs, provider-specific roles, and more

  • Claims Processing Methodologies

    Custom fee schedules with multiple qualifiers, diagnosis-specific processing

  • Auto-Adjudication

    Clean claims go from entry to payment with no user intervention. Cost-effective processing

  • Multiple Selection Criteria for Capitation Processing

    Insurance and plan-specific, age, sex, county, risk adjustment factors, and more

  • Client-Specific Customization

    No need to wait for global releases. Changes can be done as you need them

  • HIPAA Compliance

    HIPAA compliant ASC X12 5010 format including proprietary formats based on your needs

"A lot of companies say that their software can do great things, but that’s not always the case. ImagineMedMC™ can 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