EHR integration in as little as one day. We have never faced an EHR we couldn’t integrate.
Create a prior auth request with one click, our solutions initiate a powerful search from there.
Identify proof of medical necessity in 60 seconds or less. Precision Prior Auth searches the entire patient chart across all encounters.
Submit prior auths fast to any health plan. We know their medical policies and what they are looking for to reduce denials and peer-to-peers.
Track your entire pipeline of prior auth requests. Powerful search and status monitoring are at the fingertips of managers.
Maintain financial independence as a surgeon practice by obtaining authorizations faster and speeding up revenue capture
- Prior authorizations are time consuming for your staff to complete.
- Claims are rejected because of insufficient proof of medical necessity.
- Transferring information to the facility where you are operating, whether it’s at a hospital or an ASC.
- Patients are asked the same questions over and over again creating a negative experience.
- Digital prior authorizations with all the health plans you accept.
- Digital generation of medical necessity proof.
- Digital surgical consents.
- Integration between your office EHR and the facility EHR.
- Automated and digital H&Ps.
- Digital surgery booking.
- Maintain independence by keeping the EHR of your choice while also streamlining the transfer of information from your office to the facility where you are operating.
- Save hours on repetitive administrative tasks such as H&P dictations.
- Track outcomes (patient reported and clinical) to increase attractiveness to health plans establishing narrow networks.
Operate at the scale of a larger system on the budget of an ASC. Integrate with your surgeons’ office EHRs. Speed up authorizations, achieve in-network status, and keep more profit through reduced claims processing costs.
- Manual processes are labor intensive and expensive.
- Competing against larger delivery systems can be a difficult.
- Obtaining in-network status
- Technology solutions are expensive and ineffective. There’s a reason why ~80% of ASCs are paper-based.
- High degree of variation between surgery centers in a network run by an ASC management company.
We integrate with the office EHR systems of all the surgeons who operate at the ASC and we deploy a light-weight solution at the ASC to absorb the data that comes over.
We use those integrations to:
- Automate prior authorizations
- Verify eligibility
- Identify patients who are good candidates for surgery at the ASC
- Send medical history summaries to the anesthesiology group to evaluate patients
- Create digital H&Ps
- Manage surgical consents
- Generate H&Ps based on the surgeon office EHR
- Book surgeries digitally
- Track pre-op tasks and consults
- Send out customized patient communication messages through multiple channels of communication from pre-op through post-discharge.
- Collect patient reported outcomes
- Manage a network of ASCs with one standard solution to drive predictability, standardization, and operational agility.
- Faster prior authorizations
- Reduced claims rejections
- Reduced accounts receivable (AR) days
- Reduced claims processing costs
- Engaged patients and their family members
- Higher surgical volume through in-network status with health plans
- Proof of high-quality care through outcomes analyses.
Achieve high margin surgical service lines and take on risk contracts with confidence.
- Increasing profit margins seems out of reach.
- Taking on value-based payments appears risky.
- Managing prior authorizations and managing claims is slow and laborious.
- Retaining surgeons is a constant struggle.
- Technology is expensive and ROI is low.
- Adding new centers and practices involves significant effort and expense.
- Patient portals and educational initiatives have limited effect.
- Change and adaptation is slower than desired.
We start with integrating with surgeon office EHRs, the EHR at the hospitals and the EHRs across the delivery system.
We use those integrations to:
- Automate prior authorizations
- Verify eligibility
- Identify the patients at greatest risk for cancellation and readmission
- Manage the pre-screening process
- Send out customized patient communication messages through multiple channels of communication from pre-op through post-discharge.
- Collect patient reported outcomes.
- Manage surgical consents
- Generate H&Ps based on the surgeon office EHR
- Book surgeries digitally
- Track pre-op tasks and consults
- High profit margin surgical service lines
- Faster insurance prior authorizations
- Reduced claims rejections
- Reduced cancellations
- Reduced readmissions
- Improved patient experience
- Retain surgeons
- Strengthen connections with primary care physicians
- Engage patients and their designated family members (or friends)
Optimize the site of surgical care, digitize medical policies to enable more rigorous and automated prior authorizations, and provide financial transparency for patients in care decisions.
- Ineffective prior authorization solutions with little clinical rigor.
- Labor intensive and administratively expensive prior authorization process involving paper and fax.
- Unstructured medical policies that are expensive to develop, difficult to update, adjust, and evaluate.
- Lack of financial transparency for plan members.
- Digitizing medical policies.
- Mapping digital medical policies to prior authorization forms.
- Providing digital solutions for surgeon offices and facilities to electronically submit prior authorizations.
- Managing surgeon referrals, in particular in collaboration with primary care network on global budget arrangements.
- Patient-facing solutions to create cost transparency.
- Streamline payer and provider interactions (e.g., prior authorizations) to drive administrative simplification and to improve the member experience while maintaining the “sentinel effect”.
- Significantly expand the use of more cost-effective sites of care supported by robust analyses of medical necessity and outcomes that can power surgeon referrals and the prior authorizations.
- Utilize best in class medical policies that yield better outcomes at a lower cost.
- Enable the modeling and analysis of potential medical policy changes.
- Support value/risk-based contracts and global budget collaborations through referral management and site of care optimization.
- Improve the member experience by providing greater orientation/engagement and financial transparency to prevent surprise bills across the surgical episode of care and information that may influence treatment location decisions.
We integrate with any EHR system. Epic, Cerner, Athenahealth, name it, we can integrate with it. We then deploy solutions which utilize data from one or more EHR systems to drive financial performance, whether you’re a hospital, surgery center, surgeon group, or integrated delivery system.
Here’s what some of them are saying about our solutions.