Medical Management Plus
Medical Management Plus, Inc. is dedicated to making healthcare make sense through data mining, analytics, and compliance expertise. They focus on Medicare rules, regulations, and policies, providing insights and tailored services to healthcare facilities of all sizes. Their mission is to help healthcare providers grow, compare, and protect their Medicare Fee-for-Service business, ensuring compliance and optimizing performance. They also provide specialized knowledge and updates on Medicare policies, billing, and compliance to improve healthcare delivery and reduce improper payments.
Industries
Nr. of Employees
small (1-50)
Medical Management Plus
Birmingham, Alabama, United States, North America
Products
Compliance assessment and remediation platform
Analytics platform that evaluates documentation, coding and claims against Medicare rules to produce standardized risk scores and client-specific remediation plans.
Executive benchmarking and risk dashboard
High-level dashboard and reports that summarize compliance risk, key performance indicators, and peer benchmarking for executive decision-making.
Compliance assessment and remediation platform
Analytics platform that evaluates documentation, coding and claims against Medicare rules to produce standardized risk scores and client-specific remediation plans.
Executive benchmarking and risk dashboard
High-level dashboard and reports that summarize compliance risk, key performance indicators, and peer benchmarking for executive decision-making.
Services
Conduct client-specific assessments of documentation, coding and billing practices and deliver a prioritized remediation plan aligned to Medicare policy and claim risk.
Execute focused coding reviews and validation audits (quarterly or ad hoc) with education and process recommendations based on findings.
Deliver ICD-10 training, query best practices aligned to professional standards, and ongoing educational programs via webinars and workshops.
Analyze denial sequencing and trends, prepare appeal documentation, and advise on routing and strategy for contractor- and beneficiary-level appeals.
Monitor CMS, MAC, QIO, CERT, OIG and other contractor publications (including TPE articles) and deliver concise briefs summarizing policy or transmittal changes and operational impact.
Validate billed drug units against administration records and packaging, advise on HCPCS/CPT code selection and MUE implications, and recommend charge master multipliers adjustments.
Conduct client-specific assessments of documentation, coding and billing practices and deliver a prioritized remediation plan aligned to Medicare policy and claim risk.
Execute focused coding reviews and validation audits (quarterly or ad hoc) with education and process recommendations based on findings.
Deliver ICD-10 training, query best practices aligned to professional standards, and ongoing educational programs via webinars and workshops.
Analyze denial sequencing and trends, prepare appeal documentation, and advise on routing and strategy for contractor- and beneficiary-level appeals.
Monitor CMS, MAC, QIO, CERT, OIG and other contractor publications (including TPE articles) and deliver concise briefs summarizing policy or transmittal changes and operational impact.
Validate billed drug units against administration records and packaging, advise on HCPCS/CPT code selection and MUE implications, and recommend charge master multipliers adjustments.
Expertise Areas
- Medicare Fee-for-Service compliance and policy interpretation
- Claims data analytics and benchmarking
- Coding audit and medical record validation
- Clinical documentation improvement (CDI) and coder education
Key Technologies
- Medicare fee-for-service claims data analysis
- Claims-driven risk scoring and prioritization
- Regulatory surveillance and alerting systems
- Coding audit frameworks and record review tools
News & Updates
Analysis of beneficiary appeals, hospital discharge reviews, and quality improvement initiatives across regions.
Information on the transition to new regional structures, updated contact information, and temporary review pauses.
Details on Medicare improper payment rates, causes, and strategies for prevention, focusing on hospital outpatient and inpatient claims.
Analysis of improper payments, root causes, and recommendations to reduce errors in Medicare Part A hospital claims.
Latest updates on coding, billing, coverage, and policy changes affecting Medicare providers.
Implementation of RTMD Data Analytics Model
Developed a comprehensive analytics model to identify trends and improve Medicare compliance.
Analysis of beneficiary appeals, hospital discharge reviews, and quality improvement initiatives across regions.
Information on the transition to new regional structures, updated contact information, and temporary review pauses.
Details on Medicare improper payment rates, causes, and strategies for prevention, focusing on hospital outpatient and inpatient claims.
Analysis of improper payments, root causes, and recommendations to reduce errors in Medicare Part A hospital claims.
Latest updates on coding, billing, coverage, and policy changes affecting Medicare providers.
Implementation of RTMD Data Analytics Model
Developed a comprehensive analytics model to identify trends and improve Medicare compliance.