Medical Evidence Gathering and Analysis
EHR Doctors is a leader in Medical Evidence Gathering and Analysis (MEGA) software in support of insurance claims. EHR Doctors is a health IT partner with the Social Security Administration which is the largest disability insurance plan in the United States and an important safety net for all Americans, on their MEGA Health IT project. As SSA’s partner, we developed technology to help SSA gather coded medical evidence over the NHIN in support of claims. This technology is usable by any health plan in the world. MEDIBRIDGE.NET technology allows health plans to discover patients, query and retrieve electronic medical documents. It includes technology to exchange patient consent forms as needed.
HIE requires Health Plans to coordinate with the providers in their network. EHR Doctors can help you work with Hospitals and Large physician groups in your network to adapt their electronic health records into standard interoperable formats and make them searchable and retrievable by you. ROIs can be done totally automatically, with no intervention from the providers HIM staff or billing department.
Coded. Complete. Machine Readable.
Our process ensures all documentation is present including Problems, Procedures, Labs, Medication, Allergies, Vitals, Family and Social History, Physicals, Advanced Directives, Discharge Summaries, and any other reports needed. These data elements and documents are fully machine-readable, and discrete data is coded using ICD9, CPT4, LOINC, SNOMED, or any standard terminology, regardless of what terminology the health provider uses. Our method allows you to use the gathered data in decision support systems and for business intelligence. We also have technology to semantically tag unstructured data as structured data to increase the level of data usability.
EHR Doctors works with the Centers for Medicare and Medicaid to support MAC/RAC audits. Our technology allows health care providers to push requested Records to CMS for purposes of RAC/MAC audits. This uses the same technology as the SSA system, except this is a Provider to Health plan push of information. It is also a value to any Health Plan as part of your HIE technology platform. Health plans can also use secure messages as a new form of communications with the patients and providers in-network.
Our technology includes all medical data needed to make a complete adjudication or audit of an insurance claim. It gives you the information you need, much faster than any paper process. All of our public experience has readied EHR Doctors to being working with private insurers to solve the adapt this technology to your use. Contact us to learn more.