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MCM's Proprietary Claims System
MCM's Technology Advantage Among all our considerable technology investments, the one in which we've focused the greatest amount of time, energy and money is our claims processing system. We are excited to share with you its wide range of capabilities, which permit us to provide you with precise, reliable service:

  • Self-Adjudicating Accuracy
    We've developed "smart" software which insures all claims are paid exactly once and always for the correct person for the correct plan and within the provisions of the plan.

  • Flexible Funding Capabilities
    We can run checks for claims payments on a weekly or monthly basis. If you require a different payment frequency, please contact us and we will be happy to make system adjustments specific to your needs

  • Full Audit Capabilities
    All claims processing is handled properly in accordance with source document(s) and is properly adjudicated (see above).

  • Built-In Self-Validation
    Before any claim is cleared for payment, the system employs a self-validating mechanism that insures the employee has corresponding coverage, a valid diagnosis and determines whether the doctor is or is not in the network and adjusts accordingly if necessary.

  • Prompt Claims Payment
    For approximately 90% of all "clean" claims (i.e. not requiring additional oversight or raising any flags in the system), no more than 30 days will pass between the claim first being received in the office and the payment being processed.

  • No Deposits Required In Advance for Claims Payment Fund
    Our system has been optimized to assist in our long-standing business procedure of funding claims as they are processed. This reduces "up-front" financial responsibilities on your part when you become a client of MCM.

If you have specific questions regarding our claims processing system, please contact us at your convenience.

MCM Maxcare is a preferred provider network of Medical Claims Management
Medical Claims Management, Inc. · P. O. Box 1176 · Tallahassee, Florida 32302
850-553-4644 · Fax: 850-402-8961
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