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Our Payer Management Solutions (PMS) platform offers value driven integrated case management solutions for Home Health Care Payers – allowing Payers to manage all aspects of their providers’ business. With our revolutionary Payer Management Platform, the Payer becomes dynamically “linked” to all their providers, creating a shared real-time environment where case management, communication, referral & authorization management and billing all take place.

 

Optimize Operational Efficiency

As the trends in healthcare move away from hospitals, there is greater emphasis on preventative, ambulatory and home care settings. Our software provides the management tools to assist Payers in optimizing their operational efficiencies to excel in the transforming Care & Delivery Systems – creating a powerful return on investment.

Guarantee Patient and Payer Health

Payers of home health care services must be conscious of expenditures on all levels and make an effort to reduce costs, eliminate fraud, abuse and waste to maintain fiscal health, while ensuring high standards of care for members. To thrive and continue to maximize profitability in today’s marketplace – Payers must raise the bar in terms of provider accountability. Our product helps balance patient care with cost efficiency by real-time interactive authorization management.

Transparency & Control to Manage the Chronic Care Population

PMS offers unparalleled real-time visibility into your provider operations. Payers typically become aware of what actual home health services were provided or instances where missed visits occurred at the time of billing. Having access to information in real-time creates a shift from reactivity to pro-activity, where strategic efforts can be made to ensure patients’ safety, and prevent any avoidable adverse health effects and costly hospitalizations. PMS provides the platform necessary for greater control of clinical, financial and operational processes. Our innovative software enables a Payer to have a single composite view of schedules, services and data collected by providers across any particular state or region. Our software bridges the gap between Payers and Home Care Providers, essentially “un-silo-ing” entities. The Payer controls the scheduling & authorizations, so providers of care can never create and bill for unauthorized visits or services.