» Frequently Asked Questions

What does MCR do?

MCR electronically reviews the payor or the company’s health claims via a secured file transfer protocol (SFTP). This scrubbing process reviews thousands of claim files in a matter of minutes, identifying errors and saving you money.

How does the software work and how does MCR audit files?

The MCR code editing system is 100% electronic. MCR has over 1.4 million edits in its scrub engine, which means no manual review is involved or necessary. MCR typically receives claim file data via a secured file transfer protocol (SFTP), and can scrub literally thousands of claim files in a matter of minutes.

How is data exchanged?

MCR data transmission uses two different methods:

1. Using the www.mcrreview.com Web site, data is encrypted using 128-bit Secured Socket Layer (SSL) and is guaranteed by Verisign. Recognized as the industry leader in data security, Verisign is used by most financial institutions today.
2. MCR also uses the Secure File Transfer Protocol (SFTP), a Federal Information Processing Standard (FIPS) certified secure data exchange. This is the highest level of cryptographic validation currently available in the United States, and the same process used to insure the integrity of data exchanged between federal institutions. Please note: MCR meets or exceeds all HIPAA requirements.

What happens once errors are detected?

Since the software will “scrub” the claims before payment to providers, the errors will be noted and corrected, thus saving your organization from paying providers incorrect amounts.

What differentiates MCR from other coding software?

The difference is in our coding edits. We offer a more in-depth and clinically comprehensive electronic review than what exists elsewhere in the marketplace today.

Will my company ever be billed for coding errors it has detected on its own?

Your company is never billed for savings it has already generated through another scrubber. MCR only receives a percentage of the net savings it actually generates for your company.

Does MCR conduct audits on dependants on the policies as well?

MCR does not audit dependent eligibility for health plans; however, we have a relationship with a company who does and is extremely successful.

How is MCR compensated?

Medical Claims Review offers three pricing options. Please contact us for additional information.

1. A percentage of net savings;
2. Per employee or per member per month; or
3. Per claim per month.