About

HISTORY

MCSI was founded in 1997, with the purpose of creating automated health claim software. The company's founders were convinced that they could "build a better mousetrap", and providing tools to automate healthcare transactions and the surrounding complex business rules became our primary mission. Our design goal was to ensure that the application allowed the end-user to manage and implement business processes without the need for custom software development. Claims examiners, eligibility experts, review nurses, provider relations staff and other domain-specific experts create better business rules than software programmers.

With this in mind, MCSI set out to create a configurable system where experienced business people could capture their acumen making it available and repeatable to business processes without risk of losing critical details in translation as they are passed back and forth between the source of knowledge, various layers of business analysts and project managers, and finally to programmers. MCSI wanted to create a system with an intuitive approach to allowing experienced staff capture their knowledge directly into automated business rules.

The result was MCSI's flagship product: Impact - which automates claims processing, enrollment, cost containment and other benefit management procedures for some of the largest and some of the smallest TPA's, PPO's, and other claims handling organizations in the country. Impact is still the engine that powers Visova and other MCSI software products.

TODAY

MCSI is small by design, a boutique software solutions company with a solid reputation of partnering with the customer's technical staff, business experts and other vendors. MCSI expects its technical staff to fully understand the business problem and with that domain knowledge, our technicians choose the best tools for the job. Another reason for MCSI's smaller footprint is our "measure twice and cut once" mentality. Not only does this approach reduce the amount of staff required but also it creates solid processes that do not require ongoing attention to handle exceptions and outliers. MCSI prides itself on its professionalism, efficiency and creativity.

EXPERIENCE

Our software and services have encompassed the entire gambit of healthcare transactions and processes including: enrollment, authorizations, case management, customer service, notifications, repricing, adjudication, capitation, payments, billing, reporting, reimbursement, ach/eft, banking, web services, system admin, and all things in-between. We are continually improving the mousetrap and expanding its features based on real world workflows and business problems. As an MCSI customer, you can expect an attentive, responsible and committed partner who will stay with you to ensure your processes are battle-tested and you have peace of mind and confidence in their accuracy and stability.

INDUSTRY SEGMENTS SERVED

• Preferred Provider Organizations (PPO)
• Independent Physician Associations (IPA)
• Independent Physician Organizations (IPO)
• Physician, Hospital Organizations (PHO)
• Exclusive Provider Organizations (EPO)
• Health Maintenance Organizations (HMO)
• Comprehensive Management Service Organizations (MSO)
• Third Party Administrator (TPA)
• Accountable Care Organizations (ACO)
• Managed Indemnity Plan Organizations
• Direct Contracting Organizations
• Managed Care Organizations
• Integrated Service Networks
• Gatekeeper Environments
• Open Access Environments
• Closed Access Environments
• Out of Network Negotiators
• Specialty Risk Organizations