MEDENT medical billing and RCM support

What is MEDENT and who uses it?

MEDENT is an EHR, practice management and patient portal system for physician practices, sold by Community Computer Service, Inc., which does business as medent. Its own pages describe it as an all-in-one system and say the company is privately held and based in Auburn, New York, with more than 50 years in the business.

The vendor says development, support and services are managed in-house, and that the system runs in both cloud and client-server environments. It names independent practices and ACO networks as its users.

Which of these your account has turned on varies by practice, so we read your setup first.

Can an outside billing company work inside MEDENT?

Yes, when the practice issues the logins. MEDENT's Supported Services page has a section headed Revenue Cycle Management and Billing Services that lists outside billing firms by name.

Nucleus Align has no partnership with MEDENT. The practice keeps control of the system, and our role is the billing queues it hands over, worked on named logins under a signed business associate agreement.

What access does a billing partner need in MEDENT?

Named users with billing permissions only, created by the practice, after the BAA is signed. Nobody on our side shares a login.

Data protection terms are on our security page.

How do claims move from MEDENT to the clearinghouse and payer?

MEDENT's practice management pages say information from the patient chart flows into the eSuperbill, charge entry and posting areas. A charge is built from the visit, reviewed in billing, and then sent as an electronic claim through a clearinghouse to the payer.

MEDENT's partner list describes one company as simplifying electronic claims submission, remittances and eligibility. The pages do not name the clearinghouse a given practice uses, so we ask the practice which connection its account runs on.

Electronic professional and institutional claims use the X12 837 transactions that HIPAA names in 45 CFR 162.1102. The practice should be able to name its clearinghouse and tell us where rejection reports arrive.

How does MEDENT post ERA and 835 remittances?

MEDENT lists posting among the areas of its practice management system. HIPAA's standard for the electronic remittance advice is the X12 835 under 45 CFR 162.1602, so the file reaching the practice should be an 835 in X12 version 005010X221.

When we post, we compare each payment with what the payer should have paid, post contractual adjustments apart from patient responsibility, and flag short pays and unexplained adjustment codes for the denial queue.

What do we do inside MEDENT?

• Review charges for codes, modifiers, diagnoses and rendering provider before they post, using the Daily Billing Summary if your account has it
• Clear edits and rejections so claims go out within 24 hours of charge entry
• Submit through the clearinghouse connected to your account
• Post each ERA against the expected payment and flag short pays
• Work denials from a queue within 48 hours and prepare appeals where the record supports one
• Follow up open A/R, oldest and largest balances first
• Send patient statements and handle billing questions under rules you set

Which MEDENT reports matter for denial and A/R tracking?

MEDENT says it ships a wide range of interactive and printed reports, and lists interfaces to dashboardMD and Clinigence for enterprise reporting. Its pages do not name a specific denial or A/R aging report, so we describe what we pull by purpose and map each to whatever your account calls it.

• Charge lag: days between the visit and charge entry
• Claim status: unbilled, held, sent, rejected or paid
• A/R aging by payer: where open money sits and how old it is
• Denial trends: payers, reason codes and providers that repeat
• Payment variance: paid amount against the contract or expected amount

Your MEDENT administrator can tell us the report names that fit.

Does MEDENT produce CMS-1500 or UB-04 claims?

Check the claim type your account is set up for before planning any facility work. CMS describes the CMS-1500 as the standard claim form used by a non-institutional provider or supplier, with the National Uniform Claim Committee (NUCC) responsible for its design and maintenance.

The institutional form is the CMS-1450, also called the UB-04. MEDENT's pages describe physician practices, so we expect professional claims. If a client runs MEDENT in a facility setting, we confirm the enabled claim type before scope is set. See hospital and facility billing.

What billing mistakes are common in MEDENT?

We do not attribute defects to MEDENT. These are the general checks we run on any account, and the Daily Billing Summary is where a biller can review billing information before posting.

How we handle billing in MEDENT

We work your queues inside your MEDENT account on named logins, send clean claims within 24 hours of charge entry, post remits, work denials within 48 hours and report on charge lag, A/R by payer and denial trends. Scope and reporting are agreed at setup.

Read more about our medical billing, denial management and revenue cycle management services, or see how we support large groups and health systems. Other ambulatory systems we cover include Greenway Health, Practice EHR and eClinicalWorks, and the full list is on the EHR systems page. To talk through your MEDENT account, book a call.