Insurance Companies

Insurance Companies

Most medical cost containment programs are built around the claims summary report, the UB04. Medliminal goes beyond the UB04 and provides an enhanced medical cost containment program that examines itemized statements, line-by-line.

The Medliminal advantage is achieved through our orchestration of the Compliance Review Process between our proprietary Robotic Process Automation (“RPA”), known as H-CAT™, and our experienced nurses and certified coders. Medliminal does not merely chase trend lines based on analytics as do our competitors, rather, Medliminal’s H-CAT™ works in perfect harmony with our trained medical staff to review each claim submitted to us line-by-line.

Every payer has the right to a clean claim, and non-compliant billed charges do not constitute a clean claim. Charges for duplicated charges in disguise, non-billable services, complex unbundled codes and supplies and equipment are identified and denied with source documentation pinpointed to the specific regulation.

Why our Compliance Review is Unique:

  • We perform hospital compliance prior to payment
  • We do not require medical records for a compliance review
  • We strive to complete our review to allow ample time to meet claims processing time limits
  • We perform a pricing analysis on out-of-network claims to provide considerable savings
  • We obtain signed confirmation/settlement letters to avoid balance billing

Our RPA (Robotic Process Automation), H-CAT™, provides the most comprehensive and specialized results.