Average Ratings 0 Ratings
Average Ratings 0 Ratings
Description
It is accurate to assert that "not all DRG vendors are equal." Although their marketing strategies may be similar, these vendors generally fall into two categories: those that cater primarily to provider hospitals and those focused on detecting overpayments for health plans and payers. Much like how attorneys often concentrate on either defense or plaintiff cases, auditing vendors tend to specialize in the distinct needs, cultures, and priorities of their respective clients. Within the realm of payer-focused vendors, a diverse array of strategies for DRG auditing and overpayment detection exists. Our service offerings also include a dedicated physician review team that generates clinical validation findings, specifically addressing cases where identified issues stem from unsubstantiated clinical diagnoses made by treating physicians, which goes beyond the capabilities of coders. Our findings consistently demonstrate that our coding compliance model yields verified savings, contributing to enhanced financial efficiency for healthcare providers. Thus, selecting the right vendor can significantly impact the financial health of both hospitals and payers alike.
Description
Achieving significant advancements in both clinical and administrative outcomes, Evolent Care Partners, a healthcare system in the Midwest, has earned the distinction of being ranked third nationally for both total shared savings and the percentage of savings against benchmarks. By providing independent primary care physicians with essential capital and resources, Evolent Care Partners empowers them to engage in and thrive under two-sided payer contracts while mitigating their financial exposure. New Century Health enhances cost-effectiveness and quality of care in oncology and cardiology by leveraging clinical evidence to inform care decisions, a process that enjoys support from both payers and providers alike. Furthermore, Evolent Health Services streamlines health plan operations through a suite of comprehensive services backed by a modern, integrated platform and a genuine model of strategic partnership. Additionally, the organization encourages exploration of insights and news related to value-based care, population health, health plan administration, and various topics concerning the transformation of healthcare. Through these initiatives, Evolent aims to foster a more efficient and effective healthcare landscape.
API Access
Has API
No
API Access
Has API
No
Integrations
OpenPM
No
Pricing Details
No price information available.
Free Trial
No
Free Version
No
Pricing Details
No price information available.
Free Trial
No
Free Version
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Customer Support
Business Hours
Yes
Live Rep (24/7)
No
Online Support
Yes
Customer Support
Business Hours
Yes
Live Rep (24/7)
Yes
Online Support
Yes
Types of Training
Training Docs
Yes
Webinars
No
Live Training (Online)
No
In Person
Yes
Types of Training
Training Docs
Yes
Webinars
No
Live Training (Online)
Yes
In Person
Yes
Vendor Details
Company Name
DRG Claims Management
Founded
2009
Country
United States
Website
www.drgclaims.com/solutions/
Vendor Details
Company Name
Evolent Health
Founded
2002
Country
United States
Website
www.evolenthealth.com
Product Features
Product Features
Benefits Administration
COBRA Administration
Yes
Claims Management
Yes
Deduction Management
Yes
Disability Insurance Administration
Yes
Employee Benefits Administration
No
FMLA Administration
No
FSA Administration
Yes
Flexible Spending Accounts
No
For Brokers
No
For Employers
No
HIPAA Compliant
Yes
Health Insurance Administration
Yes
Life Insurance Administration
Yes
Online Benefits Enrollment
Yes
Premium Billing
No
Provider Management
Yes
Retiree Administration
No
Retirement Plan Management
No
Claims Processing
Adjustor Management
No
Case Management
No
Claim Resolution Tracking
Yes
Co-Pay & Deductible Tracking
Yes
Compliance Management
No
Customer Management
Yes
Electronic Claims
Yes
Forms Management
No
Paper-Based Claims
Yes
Payor Management
Yes
Policy Administration
Yes