Epic Systems is the most widely used EHR platform in hospitals and large health systems across the United States. Medtransic provides specialized billing integration with Epic's comprehensive suite, including MyChart patient engagement and Resolute professional billing modules. Our team brings deep expertise in Epic workflows to ensure seamless revenue cycle operations for practices of all sizes.
Features
Integration with Epic Resolute billing module
MyChart patient billing and payment support
HL7 and FHIR-based data exchange
Charge capture from Epic encounters
Complex coding support for hospital systems
Multi-facility billing consolidation
Regulatory compliance and audit support
Real-time claim adjudication tracking
Supported Specialties
Hospital Medicine
Surgery
Oncology
Cardiology
Neurology
Emergency Medicine
Radiology
Anesthesiology
Integration Type: HL7
Pricing: Custom enterprise pricing based on facility size, claim volume, and complexity of services.
Setup Guide
Step 1: Medtransic coordinates with your Epic administrator to establish secure HL7/FHIR data exchange interfaces. Step 2: Configure billing workflows and charge capture rules within Epic's environment. Step 3: Conduct thorough end-to-end testing with live encounter data to validate accuracy. Step 4: Go live with full revenue cycle management and ongoing Epic-specific support.
Why Choose Medtransic for Epic Systems Integration
Medtransic billing specialists are trained in Epic's Resolute Professional Billing and Hospital Billing modules, understanding charge router rule configuration and split/shared visit workflows unique to Epic deployments.
Our team handles teaching physician attestation requirements for academic medical center clients, applying correct GC and GE modifier usage to resident-supervised encounters to maintain compliance and maximize reimbursement.
We manage 340B drug billing reconciliation for oncology and infusion practices, cross-referencing dispensing records against FHIR R4 charge data to ensure compliant cost-based reimbursement under the 340B program.
Medtransic configures and monitors Epic's charge router to automatically flag unbilled charges from finalized encounters, closing the revenue gap common in large multi-department Epic installations.
Our revenue integrity analysts audit Epic's charge lag reports weekly, catching delayed charges from complex multi-provider encounters in surgery, anesthesiology, and emergency medicine before timely filing windows close.
We coordinate facility and professional component claims across Epic's Hospital Billing and Resolute PB modules, preventing NPI mismatches and duplicate charge submissions common in health system Epic environments.
How Epic Systems Integration Works
Medtransic connects to Epic via HL7 v2 ADT and charge message interfaces, pulling finalized charge slips from Epic's Resolute Professional Billing module and encounter data from the Hospital Billing module in real time. Our integration engineers configure the HL7 charge feed to capture all charge trigger events from Epic's charge router, including charges generated from order completion, procedure documentation, and nursing flowsheet entries.
Professional claims are routed through a clearinghouse (Availity or Change Healthcare) after Medtransic applies pre-bill edits against live payer fee schedules and NCCI edit tables. Facility claims are routed through Epic's configured clearinghouse path or a secondary clearinghouse we establish based on the health system's payer mix. FHIR R4 APIs are used where available to pull structured charge data for high-volume ancillary services such as laboratory and radiology.
Electronic remittance advice (ERA) is posted back into Epic's Resolute module using X12 835 transactions, maintaining accurate AR balances in Epic's financial ledger. Medtransic's revenue integrity team reviews Epic's revenue cycle dashboards daily, using Epic's built-in reporting tools to track charge lag, clean claim rates, denial reasons, and payment velocity across all departments and billing providers.
Benefits of Epic Systems Integration
Charge router rule configuration catches missed charges from complex multi-provider and multi-department Epic encounters before claims drop.
Teaching physician attestation audits ensure split/shared visit documentation meets CMS requirements, protecting academic medical center reimbursement.
340B drug billing reconciliation aligns dispensing records with FHIR charge data, maintaining compliant infusion and oncology reimbursement.
FHIR R4 integration enables structured, real-time charge capture for ancillary services without manual data re-entry across Epic modules.
Pre-bill scrubbing against live payer fee schedules catches Epic-specific NCCI bundling conflicts before claims reach the clearinghouse.
Common Billing Challenges We Solve
Incomplete charge capture in the Epic charge router — charges that fire triggers but fail to complete due to missing provider attestation or unsigned orders remain unbilled.
Facility NPI mismatches on multi-campus claims when Epic's billing configuration does not correctly assign the rendering facility's Type II NPI.
Stale benefit verification cache in Epic's MyChart causing coordination-of-benefits denials when secondary payer information is outdated in the patient's record.
Split/shared visit documentation deficiencies where resident and teaching physician contributions are not separately time-stamped, triggering medical necessity denials.
NCCI edit conflicts when Epic's grouper logic applies facility bundling rules that differ from payer-specific ambulatory surgery center or professional fee edits.
Frequently Asked Questions About Epic Systems Integration
How does Medtransic submit professional and facility claims through Epic?
Epic uses the Resolute Professional Billing module for physician claims and the Hospital Billing module for facility charges. Medtransic connects via Epic's HL7 and FHIR interfaces to pull finalized charge slips and encounter data, then routes professional claims through a clearinghouse (Availity or Change Healthcare) and facility claims through Epic's own clearinghouse connection. We configure Epic's charge router rules to flag unbilled charges automatically, minimizing missed revenue.
What denial patterns are most common in Epic-based health systems?
Epic environments frequently see denials from incomplete charge capture in the charge router, missing or mismatched NPI on facility claims, and coordination-of-benefits errors when Epic's benefit verification cache is stale. Complex multi-facility organizations also encounter bundling edits when Epic's grouper logic conflicts with payer-specific NCCI edits. Medtransic runs pre-bill scrubbing against live payer fee schedules to catch these before submission.
How does eligibility verification work within Epic and how does Medtransic enhance it?
Epic's real-time benefits check pulls eligibility via X12 270/271 transactions at scheduling and check-in through Epic's MyChart or front-desk workflows. However, Epic's built-in verification does not always surface secondary payer coordination or deductible accumulator data. Medtransic runs an additional batch eligibility sweep 48 hours before each appointment date and flags discrepancies for staff review, reducing front-end eligibility-related denials by over 30%.
Epic primarily serves large health systems and academic medical centers. What specialty billing complexities does Medtransic handle?
Academic medical center Epic deployments involve complex billing scenarios including teaching physician attestation rules, split/shared visit documentation for resident encounters, and 340B drug billing for oncology infusions. Medtransic's Epic-trained coders audit teaching physician documentation, apply appropriate modifier GC/GE usage, and reconcile 340B claims against the dispensing data to ensure compliant reimbursement for oncology, anesthesiology, and emergency medicine departments.
What does the go-live process look like when transitioning a health system's billing to Medtransic within Epic?
Medtransic coordinates directly with the Epic technical build team to establish HL7 ADT and charge message interfaces, typically requiring 6-8 weeks for an enterprise health system. We run a 4-week parallel billing period — submitting claims through both legacy and Medtransic workflows — before cutting over fully. Post-go-live, a dedicated Epic revenue integrity analyst reviews charge lag reports weekly for the first 90 days to catch any missed charge triggers.