MedCom Solutions

MedCom Solutions is a Pittsburgh-based healthcare revenue cycle firm that has helped hospitals and health systems recover net revenue for nearly four decades. Since its founding in 1986, the company has built its practice around a single promise: accurate charge capture translates directly into resources that healthcare organizations can reinvest in patient care. With 35-plus years in business, eight patents, a 93% client retention rate, and a documented 300%+ ROI for clients, MedCom brings a track record that most back-office outsourcing providers cannot match. The company's core services cover the full charge integrity lifecycle. Charge Capture Services give healthcare organizations granular control over charge processes through multi-layered volume comparisons, order entry to CDM mapping reviews, and chargemaster analysis at the CPT code and revenue code level. Surgical Charge Services model the cost and complexity of operative encounters against reimbursement terms to build defensible surgical charge structures. Strategic Pricing Analysis draws on proprietary methodology to identify systemic underpricing, and past engagements have surfaced net revenue improvements in the hundreds of millions of dollars. Compliance auditing rounds out the offering, including Medicare 72-hour rule reviews and 835 Remittance reconciliation work that catches overpayments and underpayments that automated systems routinely miss. MedCom serves hospitals and academic medical centers across the United States, with particular depth in large, complex facility types where chargemasters can exceed 75,000 line items. The company has worked with regional community hospitals, major urban academic centers, and national hospital management organizations, giving its consultants exposure to a wide range of payer mixes, IT environments, and regulatory situations. What separates MedCom from general healthcare BPO or medical billing vendors is its proprietary software platform. The firm developed its first pricing software in 1986 and has continued building clinical and financial tools ever since, including the CMNavigator chargemaster management system and the OIG-72 Compliance Audit product. That combination of internally developed technology and on-the-ground consulting expertise means clients work with people who understand both the data and the workflows, not just one or the other. The company also maintains a formal corporate compliance program covering privacy and security standards, business ethics, confidentiality, and business associate agreements. If your hospital or health system is leaving revenue on the table through charge capture gaps, pricing misalignment, or compliance exposure, MedCom Solutions is worth a direct conversation. Reach out through their website to discuss where revenue recovery opportunities may exist in your organization.