Best Healthcare Payer Care Management Workflow Applications for Enterprise - Page 2

Connexall is a hospital-wide event management and control platform. It was ranked number one in the 2015/2016/2017 awards and 2018 Best in KLAS Awards. It acts as a backbone to clinical workflow by communicating the correct information to the right person at the right time on the right device. The Class II medical device software, based on more than 20 years worth of R&D, is completely vendor-neutral. Connexall has offices located in Canada, Brazil, Portugal, Hong Kong, and the United States. It works with more than a thousand of the most innovative and renowned hospitals and health systems around the globe.

Clinics that have outpatient services and possess over 20 beds, as well as facilities such as laboratories, radiology departments, pharmacies, and collaborations with insurance providers, are included. Hospitals offering both outpatient and inpatient care, along with services like laboratories, radiology, operating theaters, ambulatory services, medical records departments, pharmacies, and insurance partnerships, fall under this category as well. Additionally, hospital chains that operate multiple branches across various locations, providing specialized services such as ophthalmology and diabetes care, are relevant. Lastly, educational institution-affiliated hospitals that cater to specific requirements, including the preparation of MCI reports, are also encompassed within this framework. This comprehensive overview highlights the diverse array of healthcare facilities and their operational needs.

Introducing the first-ever intelligent medical billing software that caters to multiple specialties. It simplifies the billing process and enhances patient collections for over 75,000 healthcare providers nationwide. With its global data capabilities, there's no longer a need for entering information multiple times. Designed to handle large volumes and intricate data, it features a flexible data structure that meets the diverse needs of various practices and specialties. This software ensures that you receive payments more quickly. You can input payments manually or utilize electronic remittance options. Claims are automatically scanned for errors and any missing details, ensuring accuracy. Additionally, the software can automatically resubmit insurance claims based on predetermined criteria. The rapid review feature allows for swift evaluation and approval of charges. You can audit charges by various metrics, including modality, procedure, insurance, user, or date of service. The intuitive reporting system provides insights into the financial well-being of both front-end and back-end billing processes. You’ll never miss a charge again. Furthermore, it seamlessly integrates with your chosen clearinghouse or statement vendor, making it a versatile choice for healthcare billing. With its user-friendly interface and comprehensive features, this software is set to transform the way medical billing is handled in practices.

YASASII® is a cutting-edge, comprehensive Healthcare Information System (HIS) designed for use by healthcare professionals in a variety of settings, ranging from primary care centers to advanced multi-specialty hospitals. Its intuitive and user-friendly interface promotes seamless operation across all departments, helping to prevent revenue loss for your organization. The system prioritizes the integration of clinical, financial, and administrative aspects of a healthcare enterprise. By providing a wealth of information through our decision support tools, YASASII® aims to alleviate the workload for healthcare providers while enhancing both the quality of care and the workflow efficiency of the facility. Notably, YASASII® is characterized by its ease of use, comprehensiveness, integration, intra-operability, scalability, competitiveness, and adaptability. For all your healthcare industry requirements, don't hesitate to reach out to your IT solutions partner, who can assist you in optimizing your healthcare operations. This partnership can lead to improved patient outcomes and a more productive work environment.

Simple Interact is a SaaS provider focused on enhancing the operations of medical practices, groups, and hospitals. Our technology accelerates patient workflows while minimizing the need for additional staffing. By automating a variety of repetitive tasks, we alleviate the burden on staff. This includes managing intake processes, capturing images such as insurance cards and selfies, and handling medical histories, screenings, legal documents, informed consents, initials, eSignatures, and educational marketing materials. Additionally, we facilitate the automated filling of canceled appointment slots and streamline appointment and referral request forms along with request management. Our system also offers features like patient self-sign-in with address and insurance verification, a virtual waiting room, and reminders and consent for telehealth services, ensuring a comprehensive solution for modern medical practices. Ultimately, our goal is to create a more efficient and patient-friendly experience in healthcare settings.

Axxyr offers a comprehensive system designed to seamlessly link various health settings, such as multi-location practices, clinics, hospitals, and even individual doctor's offices. Clients can anticipate a hassle-free transition to Axxyr from their previous systems, ensuring minimal disruption to their operations. Our onboarding process is tailored to meet the specific requirements of our clients, guaranteeing that the delivered software aligns perfectly with their needs, stays within budget, and adheres to timelines. Built using adaptable Java technology, Axxyr effortlessly integrates with HIPAA-compliant devices and allows for customization at the screen level. With Axxyr, all essential elements to manage patient information flow are readily accessible, covering everything from patient arrivals and wait times to scheduling resources, equipment, rooms, inventory usage, billing, follow-up appointments, and reminders. This ensures that healthcare providers can focus on delivering optimal care while we handle the operational complexities.

Duplicate patient records lead to mistreatment and soaring costs. At 4medica, we assist in transforming health data errors into dependable data quality, enabling you to function at peak efficiency and deliver more impactful care to those who require it most. Our data quality platform significantly enhances your data health, making the concept of “one patient, one record” achievable. Consider us the headquarters for Health Data Quality (HDQ). Health data quality refers to the evolution of health data over time—its accuracy, location, and timing—and its overall utility. High-quality data is essential for our healthcare system, particularly as it increasingly shifts towards digital recording and storage. By refining data to be more sophisticated and applicable, you can unlock improved care coordination, deeper clinical insights, and ultimately, a healthier community, fostering a more effective healthcare environment. As we navigate this complex landscape, prioritizing data quality remains paramount for achieving health equity and better outcomes.

AirStrip ONE, in conjunction with Tricefy, offers a centralized hub for medical images, patient information, and waveforms, all accessible through an advanced viewer. By completing the form below, you can discover how the partnership between AirStrip and Tricefy can enhance care quality and decision-making processes in your organization. The core philosophy of the AirStrip ONE® digital healthcare platform is based on interoperability, ensuring seamless communication across various systems. Equipped with robust cybersecurity measures, AirStrip ONE® is utilized by healthcare teams across mobile devices, laptops, and desktops, enabling them to effectively monitor patients throughout the entire continuum of care. At AirStrip, we prioritize your privacy and confidentiality above all. Through the development of cutting-edge technology, AirStrip® is dedicated to making significant and enduring advancements in global healthcare delivery, facilitating collaboration among clinicians for improved patient care. Additionally, AirStrip offers a comprehensive, vendor-neutral, and enterprise-wide mobile interoperability platform that not only enhances care collaboration but also propels innovation within health systems. This commitment to innovation ensures that healthcare providers have the tools they need to respond effectively to the evolving demands of patient care.

Medinous is a web-enabled, fully integrated Hospital Management System that can be used by large and mid-sized hospitals and clinics. It was designed for simplified operations, superior patient care, and increased administration & control. Our goal is to integrate and automate your entire hospital's process flow, including clinical areas, support functions, finance, supply chain, administrative, and billing functions. We facilitate quick integrations to PACS, Lab/Medical Equipment, Drug Databases, and Payer Connections for ease of use.

An all-encompassing hospital management system designed for mobile platforms. This includes applications tailored for Doctors, Nurses, Administrators, Patients, and Pharmacy staff. With just a tap on their smartphones or tablets, healthcare providers can manage all institutional operations seamlessly. Each day presents a challenge for physicians as they strive to provide their patients with the focused care they need within the restricted time available for each consultation. As visits become more intricate, partly due to simpler cases being diverted to walk-in clinics, the pressure intensifies as appointment schedules tighten further amidst the ongoing difficulties of securing adequate reimbursement. Adopting such technology could significantly ease these burdens and enhance overall patient care.

A hospital management system offers a modern and automated approach to overseeing hospital operations, moving away from traditional methods. It efficiently handles essential functions such as inpatient and outpatient management, billing, laboratory testing, bed allocation, financial accounts, and human resources. Additionally, it facilitates the easy generation of various reports—daily, weekly, monthly, semi-annual, and annual—covering sales, revenue, patient statistics, laboratory tests, and bed occupancy based on your specifications. Accessing these reports is as simple as clicking a few options within the software. Importantly, administrators have the capability to monitor all activities and personnel through this system. The inclusion of an internal messaging feature fosters seamless communication among staff members. Ultimately, clinic management software not only keeps you aligned with current trends but also empowers you to manage your healthcare business operations digitally and with remarkable efficiency. This comprehensive system enhances overall productivity and collaboration within the hospital environment.

We have created a cloud-based software solution that not only addresses the IT needs of healthcare institutions but also offers a comprehensive, all-encompassing approach that supports every stakeholder involved. This platform streamlines daily operations across various healthcare facilities, enhancing administrative oversight while contributing to superior patient care and heightened satisfaction levels. Featuring a cutting-edge, fully integrated hospital information management system, it aims to optimize the quality of patient care. Additionally, our robust and user-friendly Path-Lab Management System utilizes the latest technological advancements to enhance performance. This system is meticulously crafted to fulfill all operational demands and deliver extensive pharmacy services. Furthermore, it is designed to boost your profitability by granting you complete control over clinic operations. By joining Practo’s network, you can elevate both your revenue and patient experience while effectively reducing costs. Embracing this innovative solution allows healthcare providers to thrive in a competitive landscape.

Writer Information presents a comprehensive Hospital Information Management Software designed to streamline system automation, enhance operational efficiencies, and address the challenges encountered in patient care while also lowering costs. This innovative software allows for seamless electronic exchange of health data, enabling healthcare providers to offer superior and safer care to their patients, which translates into significant improvements for their organizations. By leveraging this automated solution, medical facilities can effectively tackle many of the critical issues currently plaguing the healthcare sector, achieving better operational efficiencies, implementing advanced electronic medical record (EMR) technologies, and maximizing patient care while increasing revenue through enhanced services and offerings. Additionally, our platform is integrated, scalable, and multilingual, making it adaptable to fulfill diverse communication and information requirements across multiple facilities. This versatility ensures that healthcare providers can tailor the software to their specific needs, ultimately improving the quality of care delivered to patients.

The hospital management solution, which encompasses multiple establishments and activities (MCO, SSR, PSY, HAD), serves as a robust foundation for a comprehensive and integrated information system tailored for healthcare facilities. It is divided into various business modules to cater to the unique requirements of individual health institutions. The hospital manager effectively addresses the organizational and strategic challenges faced by all healthcare entities, facilitating the pooling of resources and structures for managing multi-establishment operations, population health, and repositories of best practices. Additionally, it promotes efficient information exchange between hospitals, outpatient facilities, and community healthcare services. The solution ensures quality and timely support through a detailed general medical summary that is both consolidated and applicable across multiple institutions. Furthermore, it includes tools for ongoing monitoring and assessment of availability rates via monthly reports, alongside measurements of application response times, thereby enhancing overall operational efficiency. This comprehensive approach ultimately aims to improve patient care and streamline healthcare processes across the board.

Health Catalyst stands out as a premier provider of advanced data and analytics solutions tailored specifically for healthcare organizations, dedicated to driving significant, measurable improvements through data-informed strategies. Escape the limitations of fragmented data and embrace an innovative approach that prioritizes healthcare-focused analytics to unlock substantial progress. By partnering with Health Catalyst, you can transform your organization into one that operates at its highest potential. Avoid relying on disjointed analytic efforts that fail to yield meaningful results; instead, enhance your revenue, reduce costs, and improve quality by integrating AI and data science into your core frameworks. Leverage AI proactively to empower analysts and leaders, facilitating a measurable transformation that is broad, scalable, and sustainable. Additionally, broaden the application of self-service AI to become a fundamental part of your analytics strategy. With just a single click, Healthcare.AI seamlessly integrates with your current business intelligence tools and applications, making it easier than ever to harness the power of data in healthcare. This integration not only streamlines processes but also enhances the overall effectiveness of your analytics efforts.

Transforming fragmented health data into meaningful insights is at the heart of what we do. Clarify Health's analytics platform cuts through the confusion, enabling organizations to excel in a post-pandemic landscape. We provide accurate insights into the performance of healthcare providers, the experiences of patients, and the adoption rates of therapies. With our state-of-the-art analytics software, you can confidently enhance physician performance, align patients with suitable care options, and adeptly manage value-based agreements. Harness insights that can expedite product launches and foster growth, while showcasing real-world effectiveness and facilitating outcomes-based contracts. Accurately pinpoint leading physicians and facilities, offer a more tailored experience to members, and optimize value-based interactions. Our timely insights are generated through a multitude of predictive models, organizing data into real-time analyses that drive measurable return on investment. Fueled by extensive data and cutting-edge technology, we are dedicated to transforming health data into tangible results that make a difference in patient care. In this rapidly evolving healthcare environment, our platform empowers stakeholders to make informed decisions that lead to better health outcomes.

Delivering empathetic and high-quality care to rural and critical access areas is a mission of paramount significance. As the primary healthcare provider in your locality, you are a trusted resource for your patients throughout all phases of their lives, necessitating that your care teams are well-equipped with essential information for informed decision-making and effective tools to impact patient health positively. Paragon serves as an integrated electronic health record (EHR) designed specifically for rural and community hospitals, as well as single integrated delivery networks (IDNs). By providing clinical insights and decision-making support right at the point of care, Paragon enhances clinician satisfaction significantly. Additionally, it offers workflow intelligence that aids healthcare professionals in swiftly finding pertinent patient data, ensuring that critical information is available at the right moment, which leads to increased efficiency and better patient care outcomes. Our established history demonstrates that Paragon users are well-prepared to navigate regulatory requirements, healthcare reforms, pay-for-performance models, accountable care organizations (ACOs), and the evolving landscape of healthcare challenges. Ultimately, Paragon empowers providers to focus on what truly matters—delivering outstanding care to their communities.

The process of patient access serves as the foundation for the entire revenue cycle management in healthcare. By ensuring that patient information is accurate from the outset, healthcare providers can minimize errors that often lead to additional work in administrative departments. A significant portion, between 10 to 20 percent, of a healthcare system's revenue is spent on addressing denied claims, with a staggering 30 to 50 percent of these denials originating from the initial patient access phase. Transitioning to an automated, data-oriented workflow not only mitigates the risk of claim denials but also enhances patient care access, thanks to features such as round-the-clock online scheduling options. Furthermore, patient access can be refined by streamlining billing processes through real-time eligibility checks, which provide patients with precise cost estimates during registration. Additionally, enhancing registration accuracy leads to greater staff efficiency, allowing for immediate rectification of discrepancies and errors, thereby preventing expensive claim denials and the need for further administrative corrections. Ultimately, focusing on these elements not only safeguards revenue but also elevates the overall patient experience.

Facilitating connections among healthcare entities and enhancing interoperability is essential for improving both outcomes and operational efficiency. The Infor Cloverleaf® Integration Suite serves as a robust solution for the smooth exchange of clinical information, thereby contributing to better healthcare results and operational effectiveness. This software empowers healthcare organizations to tackle intricate interoperability issues securely and on a large scale, utilizing contemporary standards such as HL7® FHIR®. Serving as the foundational integration platform, Cloverleaf caters to a variety of healthcare stakeholders, including providers, health information exchanges (HIEs), accountable care organizations (ACOs), laboratories, and both independent software vendors (ISVs) and original equipment manufacturers (OEMs). It also accommodates virtualization for both private and public cloud environments, employing advanced failover and availability strategies. The scalability of Cloverleaf ensures that it can adapt to the diverse requirements of healthcare organizations of any size, while also accommodating various centralized and distributed interoperability frameworks effectively. This adaptability makes it an invaluable tool for organizations aiming to enhance their healthcare delivery systems.

CORTEX represents a groundbreaking advancement in utilization management software, delivering a comprehensive 360° solution to navigate the complexities of utilization management and revenue cycle operations. Powered by an advanced machine learning engine and real-time predictive analytics, CORTEX guarantees that cases are addressed promptly and appropriately, whether by the right personnel or through exceptions. By integrating precision medicine with a robust foundation of evidence-based practices, CORTEX enhances the evaluation of patient populations through real-time machine learning models. Our analytics solutions have been successfully implemented in hospitals and health plans nationwide, demonstrating their effectiveness. For straightforward inpatient cases, CORTEX streamlines the process by automating determinations based on your specific criteria, significantly reducing the burden on staff. In contrast, when facing challenging cases, CORTEX equips your team with critical insights to facilitate well-informed decisions. This innovative approach delivers tremendous benefits to both payers and providers, fostering improved healthcare outcomes and operational efficiency. Furthermore, CORTEX's adaptability allows it to evolve with the changing needs of the healthcare landscape, ensuring sustained value over time.

Mosaic offers exceptional insights into comprehensive market performance metrics that span various provider categories, enabling you to assess risks prior to engagement, enhance relationships, and succeed in the current value-driven healthcare environment. In the endeavor of constructing and sustaining a robust network, the effectiveness of your team is heavily influenced by any underperforming partners. Uncover strategies to tackle deficiencies and capitalize on potential opportunities. Set and accomplish targeted objectives, such as incorporating new provider types or establishing a preferred provider group. Work alongside providers to elevate quality, optimize utilization, and manage costs effectively. Ultimately, achieve a reduction in the overall cost of care while simultaneously enhancing patient outcomes, ensuring a win-win situation for all stakeholders involved. By leveraging these insights, you can foster a culture of continuous improvement and adaptability in your healthcare network.

The comprehensive platform utilizes top-tier cloud technologies to modernize the healthcare data landscape, guarantees interoperability, reduces overall ownership costs, and provides both scalability and adaptability. With Abacus Insights’ personalized data management services and a strong focus on customer needs, the challenges of change management are significantly reduced, allowing you to concentrate on enhancing robust analytical capabilities that meet your business goals. The platform features a Unified Data Foundation, which securely enhances the quality of healthcare data through standardization, facilitating the effortless distribution of real-time data to users. Additionally, industry-leading healthcare professionals are available to support the optimization of your data management processes. This approach accelerates the creation of enterprise data warehouses, operational data stores, data marts, and data lakes, ultimately granting you confidence with expert assistance for business users while also fostering a culture of data-driven decision-making.

Boost your organization's cash flow by efficiently handling claims from Medicare, Medicaid, and various commercial payers. With our automated system, you can process all payer claims in real-time from any location, ensuring faster payment for your claims. You have the ability to submit and monitor your claims at any moment, benefiting from real-time updates on their status. A dedicated account manager, who is a certified healthcare claims expert, will be assigned to you, and you will even have their mobile contact number for immediate assistance. Expand your revenue streams and enhance your cash flow through our automated claims processing, which provides complete visibility into all your electronic funds transfers (EFT) and payment forecasts. You can streamline the processing, tracking, and resolution of claims in real-time to maximize revenue and eliminate time-consuming tasks. Additionally, our system automates Medicare eligibility verification alongside claims processing to further enhance efficiency. By adopting this approach, you can significantly reduce administrative burdens and focus on what matters most—providing excellent care to your patients.

AyusLab is an innovative cloud-based LIMS software designed to enhance diagnostic businesses by improving customer engagement, ensuring quality assurance, and providing faster service delivery. This specialized LIMS solution aims to deliver high-quality services while simultaneously driving revenue growth. With a focus on a 'patient-centric' approach, the platform effectively helps you maintain a loyal customer base and promotes business acceleration. Additionally, its integrated business intelligence features empower you to plan, analyze, and refine your lab operations on a day-to-day basis. AyusLab LIMS allows for immediate access to real-time business performance metrics, providing you with comprehensive insights into your finances, billing, and receipts. Moreover, it offers robust capabilities to monitor your quality control processes, track inventory, conduct audits, ensure NABL compliance, and much more, thereby streamlining your operational efficiency. Ultimately, this software serves as a vital tool for laboratories looking to enhance their overall performance and customer satisfaction.

Acuity Advanced Care™ is a flexible on-premise population health platform tailored to meet the varied requirements of case, utilization, disease, and overall population health management initiatives. This system empowers organizations by granting them complete control over their environment while allowing for customization to cater to each entity's distinctive care strategies. Impressively, over 90% of Acuity Advanced clients hold either NCQA or URAC accreditation, or both. With Acuity Advanced Care, users benefit from the inherent flexibility that an on-premise solution provides, along with comprehensive database access. The on-premise setup enables organizations to dictate the location of their data storage. Those clients who possess skilled IT teams are capable of handling the configuration, security, and upkeep of intricate systems independently. Chordline Health stands out as a premier software provider focused on assisting health plans, TPAs, ACOs, and various risk-bearing entities. The skilled team at Chordline, composed of US-based clinicians and developers, is celebrated for its unparalleled expertise in managed care and exceptional customer service, ensuring that clients receive top-tier support and solutions for their healthcare needs.