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Medegy Health Systems
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Our Services

Simply put, at Medegy Health Systems, we manage your claims, increase your bottom line, and improve member satisfaction. We improve the way you do business.

We have more than 30 years of experience successfully managing fee-for-service (FFS) and capitation (CAP) contracts for commercial, Medicare, and Medicaid plans.

We offer reliable benefit administration as well as efficient and streamlined systems designed with you and your members in mind. Our fully integrated technology and expertise provides you the solutions you need, from assessing risks to managing costs. Our services run the gamut, including:

  • Account Management
  • Audit & Delegations
  • Benefit Plan Administration
  • Case Tracking
  • Claims Administration
  • Clinical Guidelines
  • Financial Management
  • HEDIS Programs
  • HIPAA EDI
  • Information Technology
  • Insight Outreach Campaigns
  • Laboratory Management
  • Member Bank Account Management

  • Payer Management
  • Premium Billing Administration
  • Reimbursement Management
  • Reporting
  • Secure Data Sharing
  • Support Services
  • Telemedicine Portal
  • Unified Communication
  • Utilization Management
  • Web Portal

The most popular of these TPA services are:

Analytics & Insights
  • Custom reporting
  • Auto report delivery
  • Centralized data mart
  • And more!
Claim Administration & Adjudication
  • Auto adjudication
  • Repricing
  • CMS guidelines
  • And more!
Compliance and Delegation
  • Claims delegations
  • Credentialing delegations
  • Corporate compliance
  • And more!
Customer Care
  • Call tracking
  • Log & track modifications
  • Comments and documentations
  • Bilingual services
  • Self-serve options
  • And more!
Membership Management
  • COB: primary and secondary
  • Auto enrollment & removal
  • ID card printing
  • And more!
Provider Credentialing & Contracting
  • Credentialing
  • Comprehensive directories
  • Multi-plan, multi-reimbursements
  • And more!

TPA Services in Miami, FL

Are you interested in learning more about our services? Call Medegy Health Systems in Miami, Florida, at (786) 441-8465 or toll-free at (888) 225-0535. You can also request a consultation now.

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Medegy Health Systems offer premier TPA services for specialty provider networks and health plans.