Pre-Pay Medical Compliance Review

The Medliminal advantage is achieved by combining top machine learning processes with our expert team to make sure every claim receives a thorough line-by-line review. Our Compliance Review Process begins with our proprietary Robotic Process Automation (RPA) known as H-CAT™ before being reviewed by our experienced nurses and certified coders.

Medliminal’s medical professionals examine billing errors that are well beyond the scope of a traditional audit. With less than 1% turnover rate on appeals, we’re confident that our findings are rock solid.

How the Pre-Pay Compliance Review Works For Your Company

Step 1

Hospital visit produces UB-04 and itemized bill

Step 2

UB-04 and itemized bill uploaded to secure FTP site

Step 3

UB-04

Itemized Statement

Compliance Review Performed

Step 4

Option One

Explanation of Review (EOR)

TPA Reimburses Based on Mediminal Report

Discount Applied

Planned Benefit Coverage Applied

Payment Processed

Option Two

Explanation of Review (EOR) – Includes Discount and Benefit Limits

Mediminal Settles Bill

Bill Goes to Medliminal Resolution Team

Signed Settlement Letter

To TPA for Processing

Our services

Focused services that deliver innovative solutions that reduce healthcare costs for all payers.

Pre-Pay Medical Compliance Review

Through orchestration of our proprietary RPA system, H-CAT™ and our experienced nurses and certified coders, Medliminal provides a line-by-line medical bill compliance review.

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POST-Pay Medical Compliance Review

Unlike other cost containment companies, Medliminal not only identifies medical bill overcharges, but recoups those amounts up to a 2 year look back.

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Employee Medical Bill Champion (EMBC)

Employees are often burdened by exorbitant medical costs and confused by the lack of transparency in the healthcare industry.

Medliminal’s Employee Medical Bill Champion (EMBC) is an advocate for the employee, providing guidance throughout the complexities of the medical billing process.

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