The
Claims Processing module automatically prices all
services. With this feature the MCMIS will
provide the Managed Care Organization with
increased productivity and improved accuracy by
the reduction of manual intervention. BCA’s
MCMIS also allows for pricing to be structured
globally or a combination of both. The ability
to designate particular services as “Non-Covered”
or “Capitated” prevents payment of non-contracted
services. The flexibility of the MCMIS to price
services as fee-for-service, percentage of
fee-for-service, fee-for-service plus percentage
capitation, or any combination of the above will
aid in contract negotiations for outside
services.
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