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Compliance

Expertise to simplify the complex regulatory environment

Regulatory Compliance

Understanding and providing solutions for complex federal and state health information regulations and standards is critical to your business.  Mitchell can help simplify complexities in the regulatory environment for both the Auto Casualty and Workers’ Compensation arena.

Compliance impact areas include:

EDI Reporting
  • eBilling and ePayment
  • Medical, FROI/SROI
  • CMS State Reporting
  • WCRI & NCCI DC
  • Regulatory Reporting Requirements
State Fee Schedules
  • Rules, Schedules, Guidelines
  • Utilization Tx Guidelines
Networks
  • PPOs, MPNs, HCNs, MCOs
  • Ancillary programs
Managed Care
  • Medical & Drug UR
  • Case Management
Litigation Support Strategies
Educational Services
  • Regulatory & Compliance Changes
  • Application Training
  • Subject Matter Expertise

Turn to Mitchell for P&C subject matter expertise:

  • National Compliance Footprint
  • Deep Industry Expertise
  • Dedicated Compliance Team
  • Trusted Advisors for customer satisfaction
  • Active Member and Leaders of Industry Standards Organizations
  • The source for current Legislative and Administrative News
  • Strategic Partner in Compliance

You’ll benefit from Mitchell’s consistent approach to compliance. The four step process includes:

Research
  • Monitor state/federal web sites
  • Interpretation and consultation of proposed updates
  • Adaptation to technology
Analysis & Programming
  • Requirements review
  • Fee and Rule Creation
  • Trend analysis and mitigation 
  • Release notes
  • State Specific Review guidelines
Quality Assurance
  • Unit & regression Testing
  • Peer reviews
  • Clarifications with state entities
  • Client input & engagement
Deployment
  • Builds deployed to client
  • Publication of release with comprehensive notes

Mitchell's compliance team consists of experienced Health Information Management experts credentialed under the highest level industry certifications and includes a certified Nosologist, Certified Medical Compliance Officer (American Institute of Healthcare Compliance), Registered Nurses, Certified Legal Nurse Consultants and paralegals. Medical coding certifications held by this team include Certified Professional Coder (CPC), Certified Coding Associate and Certified Coding Specialist (CCS) through AHIMA certifications.

Premier Medical Reporting

Premier Medical Reporting

State compliance management is now a straight-through process for your workers' compensation bill review operations

Regulatory Reporting

Regulatory Reporting

Mitchell’s Regulatory Reporting is an effective, integral solution set for every claims administrator’s EDI strategy.

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