MediClaims Reviews

The software is easy to use. The company has a commitment to their clients to always listen to their client's needs and great customer service.

Would like to see more automation happening with the software.

I have worked on the claims side for about 4 years and use the system extensively for claims process, auto-adjudication, reporting, FSA, and fee scheduling. There is a learning curve when it comes to setting up the system to your specifications, but once you get enough time using it, it becomes intuitive finding issues and making the system work better for your process. We rarely have issues with claims processing and we generally find the auto-adjudication and the fee scheduling to be highly useful.

There are some aspects that could be fine tuned to be better utilized. The three that come to mind is Provider Maintenance, FSA, and Reports. While there is some customization available with Provider Maintenance as far as provider types go, there could be further customization when it comes to group level. Having options in Group Edit Specifications to pend tax ID numbers or only pend certain provider...

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Ease of use, reliability, and the customer service provided when issues arise.

The request for enhancements to the software to meet the requirements of the NYS Workers' Compensation Board. Lengthy processes

A very strong feature of the software lies in the easy access to data department. You can usually tell from one, or just two, screens the overall performance and life of a member and their claims

There are two: More robust voluntary benefit administration and EDI resources (I would consider EDI to be the weakest aspect of the system.) EDI is one I am most familiar with and I find the system to lack proper flexibility when it comes to both in and out EDI claims/eligibility. More options are required in order to put forth a professional face when implementing 834, 835 and 837 files. Examples...

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The MediClaims process allows our plan designs to be unique and proprietary. We can work with Employers and Brokers and make promises and moreover deliver on those promises. Benefit exceptions can be considered because MediClaims offers outstanding flexibility when building plan designs.

I think Documentation of the system could be upgraded slightly. When I need a very specific report, I sometimes have to click around on the Headings to find what I need. Offering the option to fax from MediClaims would be ideal. Providers are constantly calling for EOB information, it would be efficient to be able to email or fax an EOB straight from WLT.

Claims administration on this system is very accurate and easy to use. WLT updates the system yearly based upon what their clients need which is a great feature. WLT is up to date with all compliances being enforced.

Plan Building portion of the system needs to have more work arounds or fixes to be able to enter in complicated or even some simple plans. We have several manual processes which is not good in our industry. Obtaining auto adjudication seems to be difficult with all of the tables/programs which need to be updated. Voiding procedures are not up to date nor easily done.

The product is easy to use and navigate for the most part. If I have questions or concerns, customer service is great to work with.

When I'm not working in the site and am logged in, I am quickly disconnected. I'd like to see the time extended before I'm disconnected.

Customer Service is good, staffing is low but improving. They are always willing to help out with any issues that crop up.

Built on old platform and has no interest in upgrading to a more modern GUI style interface.

visibly easy on the eyes, does have some good improvements in the time that i have been here, less than a year.

takes long to get updates in place. we have job fails at our warehouse at least once a week

Easy to use and user friendly software that meets our needs

Enhancements are not that easy to implement

Billing integration is what I like most about this software.

Integration and report abilities are what I like least about the software.

adjustments and resetting a claim are user friendly

coverage codes, assignment of benefits to CPT codes

It is the program that came with the job.

COB and other applications are not very useful.

Customer Service is very responsive and easy to work with.

The billing upgrade was a total nightmare.

I liked it a lot, for the trust, responsibility and service they provide when obtaining the product. satisfies customer needs and expectations.

complies with all the characteristics, and ease of use, in addition to meeting the quality standards.