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We help companies become more innovative, efficient, accelerate claims payment and reduce healthcare costs for self-insured employers and health plans. Our fastest growing markets are out of network claims processing and consulting in :
- Usual, customary and reasonable cost of care (UCR) and cost of care under the Affordable Care Act
- Usual, customary and reasonable cost of care (UCR) and cost of care under Medicaid Expansion
- Inpatient (ICD-9 and ICD-10 CM diagnosis coding and medical necessity)
- Inpatient prospective payment system (IPPS) and DRGs
- Inpatient procedure coding (ICD-9, ICD-10 PCS)
- Ambulatory reimbursement (OPPS), CPT value of care
- Mobile Health (mHealth)
- HIPAA Privacy and Security
- Behavioral health specialty medicine regulations vs. healthcare general regulations
- Accountable Care Organizations
- Investor diligence in healthcare IT
- Health care integration, BIgData, and Analytics
- Software as a Service (SaaS) application integration across Cloud Networks.
Hospital Value Based Purchasing (VPB) for Medicare
Health plan HEDIS Star Ratings Quality Measures for Medicare Advantage
Revenue Cycle Management for hospitals Medical Policy Management for health plans, Utilization Management, Case Management
ARRA HITECH Act (Meaningful Use) Electronic Medical Record (EMR) / Electronic Health Record (EHR) planning implementation and selection
Health care social media for physician and patient engagement, talent development, and organizational change management
ICD-10 Financial Reimbursment
ICD-10 Training
ICD-10 High-level review and skills inventory
ICD-10 Implementation Planning & Design
ICD-10 Risk Assessment
ICD-10 Third Party Liability
Keywords
saas, cloud computing, hospitals, electronic health records, health care, enterprise software, health care information technology, software, information technology, accountable care, social media, icd10, hipaa 5010, meaningful use of electronic health records, revenue cycle management, out of network claims settlement, pharmacy pbm, hitech act, hipaa, critical findings notification, patient protection & affordable care act
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