Maximus Canada

Medigent

Managing the business of health by expanding benefits administration capacity, enhancing decision-making capabilities, and improving communications flow

Medigent® is Canada’s leading Commercial Off The Shelf (COTS) software designed for the health care industry.

Medigent’s fully integrated modules support program management, claims assessment, and clinical surveillance and provides program management and claims processing modules for medicare, pharmacy, dental, and medical travel. As a result, healthcare providers and administrators are able to focus more on delivering services and less on administering them.

 

Medigent Components

Drug Information System (DIS)

The Medigent DIS module provides the medication portion of a patient’s complete health record by electronically linking all healthcare sites, including community pharmacies, hospital pharmacies, physician clinics, health centres, addiction centres, hospital wards, and emergency rooms with a database that maintains patient medication records. It accesses, in real-time, the patient’s entire medication profile, immunization record, and various other attributes of a patient’s clinical history, such as allergies and intolerances, medical conditions, and observations, allowing for a more comprehensive review.

Medigent provides a comprehensive DIS with the industry’s most comprehensive Drug Utilization Review (DUR) modules and ePrescribe capabilities for complete, up-to-date, and accurate medication profiles and information for improved health planning, evaluation, and research.

 

Pharmacy Claims Processing System (CPS)

The Medigent Pharmacy CPS is designed to automate and streamline the daily business processes required to manage government drug insurance programs. All claims are adjudicated in real-time. The CPS provides linkages between the services, providers, clients, and plan structures, such as covered drugs, in an integrated solution for management, adjudication, and payment.

The Special Authorization component is a critical element of Medigent’s CPS Pharmacy module; it can manage the end-to-end Special Authorization review process, from receipt to approval or denial.

 

Dental Claims Processing System (CPS)

The Medigent Dental module manages the assessment and adjudication of dental insurance claims, supporting claim submission and adjudication in real-time and batch. It can handle an intricate layering of business and financial rules and incorporates a very complex code fee structure with numerous properties, such as age restrictions, frequency limitations, fiscal elements.

The Dental module is CDAnet compliant and meets the Canadian standards for Dental Claims Processing.

 

Medicare Claims Processing System (CPS)

The Medigent Medical module is designed to automate and streamline the daily business processes required to manage a medical insurance program. It also provides claim submission and adjudication in real-time and batch. The module provides concurrent support for both existing Canadian diagnosis standards in use today, ICD9 and ICD10.

 

Medical Travel Claims Processing System (CPS)

The Medical Travel module is a full-featured claim entry and adjudication module that manages the submission, approval, and payment of claims for travel expenses related to the delivery of medical services. It utilizes a case-based sub-system to encapsulate the complete travel episode, from a patient leaving their home until they return. Travel and invoice information can be electronically loaded from other systems to automate the information-capture process.

 

Electronic Medical Records (EMR)

The Medigent EMR module is a medical practice management software designed for physicians and collaborative practitioners. It can manage Medicare claims and third-party billing in a fast and easy manner, featuring an easy-to-use extensive code search and automated reconciliation. Patient records and lab and test results can be easily accessed.

The Medigent EMR permits image scanning, and is integrated for use with voice recognition software.

 

Medigent Vital Statistics (VSS)

The Medigent Vital Statistics module is designed to automate the procedures of a jurisdiction’s vital statistics program, including the registration of births, marriages, and deaths. VSS also tracks information on adoptions, divorces, deed polls, marriage licenses, and amendments to registrations. VSS provides security, enhanced search capabilities, and accounting functionality through a graphic user interface, where users can process the registrations.