Evolution Of An Episode Of Care

Evolution of an Episode of Care

  • June 12, 2017

What does it take to bridge the gap between precision medicine, population health, and episodes of care? That's a question that can only be asked in a world moving to value. The answer was shared with attendees at AHIP Institute last week by Lili Brillstein, MPH, Director, Episodes of Care, Market Innovations, Horizon Blue Cross Blue Shield of New Jersey; and Andrew L. Pecora, MD, FACP, CPE, President, Physician Enterprise and Chief Innovations Officer, Hackensack Meridian Health; Professor of Medicine and Oncology, Georgetown University. Change Healthcare's Amy Valli asked Ms. Brillstein and Dr. Pecora for a preview of their session before…

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AHIP Social Media Ambassador Mandi Bishop Shares Her Views At This Year’s Expo

AHIP Social Media Ambassador Mandi Bishop Shares Her Views at This Year’s Expo

  • June 12, 2017

As we all know, our industry is abuzz with change. And AHIP social media ambassador Mandi Bishop has her finger on the pulse of change. Bishop is CEO and founder of Lifely Insights, bringing life context to healthcare decision-making with her active Twitter (@MandiBPro) and other social media channels. At the recent AHIP Institute & Expo 2017, she took a few minutes out of her packed schedule to speak with John Hallock, Change Healthcare VP of External Communications and Media Relations. The duo discussed value-based reimbursement, alternative payment methodologies, and how she views market consolidation. Mandi and John appeared live on…

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Reinventing Utilization Management

Reinventing Utilization Management

  • June 12, 2017

When utilization management works effectively in healthcare, everything runs better. That was the message delivered by Nilo Mehrabian, VP of Product Management at Change Healthcare, in the presentation she delivered at the AHIP Institute and Expo 2017, in Austin, Texas. Nilo discussed her session with Ian Gilbert, Senior Product Marketing Manager, Decision Management at Change Healthcare, in a live Twitter broadcast from the expo show floor. They discussed the importance of transforming UM, improving processes overall, and how to best utilize technology to help create trust between payers and providers. Get the synopsis of Nilo’s presentation, “Reinventing Utilization Management: Faster,…

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Why Financial Engagement Is The Linchpin Of Consumer Engagement

Why Financial Engagement is the Linchpin of Consumer Engagement

  • June 12, 2017

It’s happening more and more: Once medical treatment is rendered, the customer gets the bill and calls their provider asking, “What  does this mean?” At the recent AHIP Institute and Expo 2017, two leaders in the field of medical payments broke it down for attendees in their presentation, “Why Financial Engagement is the Linchpin of Consumer Engagement.” Stuart Hanson, SVP and GM of Consumer Payment Solutions for Change Healthcare, was joined by Jack Gehrke, Head of Digital Consumer Payments at Aetna. They shared statistics that reflect the challenges customers face in making sense of their coverage and invoices, and why…

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ZeOmega And InterQual Bring Prior Auths Up To Speed

ZeOmega and InterQual Bring Prior Auths Up To Speed

  • April 29, 2017

Every provider would like prior auths to be faster and easier, so they can focus on delivering appropriate patient care instead of pushing paper. Now ZeOmega, developer of the Jiva population health management platform, has integrated InterQual Connect to help make automated authorizations a reality. In this new webinar, ZeOmega demonstrates how Jiva and InterQual Connect work together to streamline and automate auth requests, making exception-based UM a reality.

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HealthTrio And InterQual Transforming UM: Rapid, Automated Prior Auths Arrive

HealthTrio and InterQual Transforming UM: Rapid, Automated Prior Auths Arrive

  • April 29, 2017

The prior-auth process has always been a challenge for providers: How to get approvals faster, so better care can go forward. Healthcare SaaS solutions innovator HealthTrio has integrated InterQual Connect into its Smart Connect portal to automate prior-authorization, resulting in faster auths and patient treatment. In this new webinar, see how nonprofit health plan CareOregon is using the solution to reduce manual work and speed appropriate patient care.  

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Put Prior-Auth On The Fast-Track

Put Prior-Auth on the Fast-Track

  • December 15, 2016

Everyone who thinks prior-authorization is a fast, efficient process, please raise your hand. No raised hands? No surprise. That’s because the prior auth process has been on the slow track for years, powered by paper, faxing, siloed software, and phone calls. Now payers can give provider networks a fast-track option for prior auth, where getting an authorization is as easy as requesting it through the payer’s care management portal. Payers like it because it reduces costs by freeing staff to tackle other things. Providers like it because it helps speed quality care. In fact, the only people who don’t like…

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Getting A Grip On Molecular Diagnostics Coverage And Payment

Getting a Grip on Molecular Diagnostics Coverage and Payment

  • November 23, 2016

Molecular Diagnostics (MDx) continue to assume a more prominent role in healthcare, and that means new challenges for payers when it comes to reimbursement, coverage decisions, utilization management, and supporting new care models. Fallon Health is taking these challenges on with an innovative approach to managing a robust MDx program. By focusing on prior authorization, enabling the clinical staff to make informed decisions, and implementing a unique healthcare IT program, Fallon cut review time up to 75%. It's possible your organization could do the same. Learn what Fallon Health did to optimize its MDx program in an upcoming AHIP webinar,…

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Learn How To Move Authorizations Into The Fast Lane

Learn How to Move Authorizations into the Fast Lane

  • October 13, 2016

Prior authorizations don't have to be a costly, tedious, or manual process. What if we could automate and streamline authorizations, so clinicians could request and receive an authorization in minutes if not seconds, without touching paper, phone, or a fax machine--and without ever leaving their preferred care management platform? We can now stop asking "what if?" McKesson and ZeOmega are bringing automated authorization with medical review to the forefront, because now ZeOmega's Jiva population health platform interoperates with McKesson’s InterQual Connect. See how it works. Discover how this partnership delivers on the promise of exception-based UM. And learn why it…

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