Products / MEDRA
Healthcare ยท Revenue Cycle
MEDRA
โ—‹ Early access

Hospitals lose revenue every month to insurance claim rejections caused by diagnosis-prescription mismatches. MEDRA catches them at the point of care, before the claim goes out.

The Problem
Insurance rejections are bleeding hospital revenue, and most are avoidable.

A significant portion of insurance claim rejections come down to one thing: the diagnosis code and the prescribed treatment don't align under the insurer's rules. These mismatches become costly reconciling items, disputes that take weeks to resolve, and revenue that often never comes back. Most could have been caught in under a minute at the point of care.

The Solution
Catch the mismatch before it leaves the building.

MEDRA runs a real-time check on every prescription against the diagnosis at the point of care, before the claim is submitted. When a mismatch is found, the clinician sees an immediate flag with a clear explanation. Fix it in the room, not in a billing dispute three weeks later. Faster approvals, fewer rejections, more revenue recovered.

Capabilities
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Real-time mismatch detection

Checks diagnosis-prescription alignment the moment a prescription is entered, before the claim is submitted.

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ICD & formulary validation

Cross-references ICD codes against insurer-specific formularies and coverage rules, updated to current coding standards.

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Insurer rule sets

Configurable per insurer. Different insurers have different rules. MEDRA knows the difference and applies the right check automatically.

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EMR integration

Designed to integrate with existing Electronic Medical Records systems. MEDRA fits into the workflow your team already uses.

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Audit trail

Every flag, every override, every resolution is recorded. A complete audit trail for compliance and dispute resolution.

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Revenue impact reporting

Track how many claims were flagged, corrected, and approved. See the direct revenue impact of mismatches caught versus missed.

Who it's for
Private hospitalsClinicsHealthcare networksMedical billing departmentsHealth insurers
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