Average Ratings 0 Ratings
Average Ratings 0 Ratings
Description
HM Health Solutions offers a comprehensive end-to-end solution designed specifically for health plans. With the Enterprise Health Solution, you can obtain the necessary support and achieve the desired business outcomes from a singular, integrated health plan administration platform. This suite of applications and tools oversees a wide range of functions, spanning from sales and enrollment to billing and claims, along with provider and clinical management, as well as customer service. The Enterprise Health Solution (EHS) stands out as the sole verified end-to-end solution that ensures a smooth transition for members from the enrollment stage all the way to claims payment. While other providers may assert that they deliver a fully integrated solution, they often fail to clarify that this may require the sequential purchase of multiple modules to realize true integration. In contrast, the Enterprise Health Solution maintains a singular focus on health plan administration, ensuring that our expertise in the payer space is unmatched. Consequently, when you choose EHS, you are opting for a platform that prioritizes your health plan’s unique needs and operational efficiency.
Description
PwC's SMART (Systematic Monitoring and Review Technology) enhances both the efficiency and effectiveness of evaluating the quality of inpatient and outpatient coding processes while establishing a framework for quality assurance and compliance reviews. In conjunction with the support from PwC Health Information Advisory, SMART reinforces your strategy for monitoring coding accuracy and overall data quality. The SMART Inpatient module features over 1,000 established business rules designed to uncover potential coding errors and opportunities for documentation enhancement, with the option to tailor business rules to meet your specific needs. Comprehensive reporting and data analysis capabilities allow for the assessment of staff performance and the identification of educational needs in areas such as Coding, Clinical Documentation Improvement (CDI), Quality, and Providers. Additionally, the SMART Outpatient module boosts claim accuracy and highlights issues related to charge capture and workflow optimization. By mitigating the risks associated with inaccurate coding, it also fosters better regulatory compliance, ultimately benefiting the entire healthcare organization. Furthermore, the integration of these tools significantly streamlines the coding review process, ensuring higher standards of care and operational efficiency.
API Access
Has API
No
API Access
Has API
No
Integrations
No details available.
Integrations
No details available.
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)
No
Online Support
Yes
Types of Training
Training Docs
No
Webinars
No
Live Training (Online)
No
In Person
No
Types of Training
Training Docs
Yes
Webinars
No
Live Training (Online)
Yes
In Person
Yes
Vendor Details
Company Name
HM Health Solutions
Founded
2014
Country
United States
Website
www.hmhs.com
Vendor Details
Company Name
PwC
Founded
1998
Country
United Kingdom
Website
www.pwc.com/us/en/products/smart.html
Product Features
Claims Processing
Adjustor Management
No
Case Management
No
Claim Resolution Tracking
No
Co-Pay & Deductible Tracking
No
Compliance Management
No
Customer Management
No
Electronic Claims
No
Forms Management
No
Paper-Based Claims
No
Payor Management
No
Policy Administration
No
Product Features
Claims Processing
Adjustor Management
No
Case Management
No
Claim Resolution Tracking
No
Co-Pay & Deductible Tracking
No
Compliance Management
No
Customer Management
No
Electronic Claims
No
Forms Management
No
Paper-Based Claims
No
Payor Management
No
Policy Administration
No