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RISE West Summit 2018
Apixio is the data science company for healthcare. Apixio’s proprietary artificial intelligence platform extracts and analyzes clinical data in electronic and PDF records, generating deep insights into patient health. These insights feed applications such as HCC Profiler, which uncovers supported HCC codes with speed and accuracy, enabling comprehensive code identification and compliance auditing for Medicare Advantage and ACA programs.
Ciox Health facilitates and manages the movement of health information with the industry’s broadest provider network. Through our expertise in release of information, record retrieval, and HIM, we improve the management and exchange of health information by modernizing workflows, facilitating access to clinical data, and improving the accuracy and flow of health information.
Episource provides a complete and integrated set of services and products to simplify the way Medicare, Commercial and Medicaid health plans manage their Risk Adjustment and Quality programs. We work with health plans and healthcare organizations to absorb the most challenging aspects of program implementation, operations, and management. We simplify by modernizing workflows to better assess the full cycle of Risk Adjustment and Quality programs to improve clinical outcomes and financial performance. Our services include: Retrospective Chart Reviews, HCC Gaps and RAF Campaign Workflow (epiAnalyst), Encounter Data Error Resolution and Financial Analytics (epiEncounter), HEDIS & STARS Analytics & Reporting, Gaps in Care Reporting, and HEDIS Retrieval & Abstraction. We also offer clinical services such as HRAs (Health Risk Assessments) and NP programs. For more company information, please contact Claudia Gallardo at (424) 295-0491, visit us at www.Episource.com, or follow us on Twitter @EpisourceLLC
Health Fidelity offers the most comprehensive, scalable risk adjustment solution for the value-based care era. Our modern prospective and retrospective RAF approaches combine big data analytics and natural language processing (NLP) technology to extract valuable insights from medical charts for faster and more accurate processing. With a streamlined coding workflow, Health Fidelity empowers risk-bearing organizations with a 360-degree view, allowing them to project, detect, and capture all commensurate member risk, and thereby risk-adjusted payments, to maximize efficiency, compliance, and reimbursement accuracy.
Pulse8 is the only Healthcare Analytics and Technology Company delivering complete visibility into the efficacy of your Risk Adjustment and Quality Management programs. We enable health plans and providers to achieve the greatest financial impact in the Medicare Advantage, Medicaid, and ACA Commercial markets as well as with Value-Based Payment models for Medicare. Pulse8 has developed a suite of uniquely pragmatic solutions that are revolutionizing Risk Adjustment and Quality Management. Our advanced analytic methodologies and flexible business intelligence tools offer real-time visibility into member behavior and provider performance. Pulse8’s products are powered by our patent-pending Dynamic Intervention Planning to deliver the most cost-effective and appropriate interventions for closing gaps in documentation, coding, and quality. For more company information or to schedule a demo, please contact Scott Filiault at (732) 570-9095 or email@example.com. You can also visit us at http://www.Pulse8.com, and follow us on Twitter @Pulse8News.
Talix provides risk and quality solutions to help providers, payers and accountable care organizations address the growing challenges of value-based healthcare. Its leading-edge SaaS applications leverage machine learning and advanced patient data analytics to transform complex data into actionable intelligence that drives improved coding efficiency and accuracy – leading to better patient outcomes, more accurate reimbursements and reduced costs.
Tessellate helps clients exceed their goals with provider-centric, low-abrasion solutions that can be implemented quickly and deliver value. Our risk adjustment, quality and provider engagement programs for health plans and provider organizations are designed to improve revenue integrity and quality of care, while lowering administrative costs. For more information, please contact Will Stabler at 804.310.9908 or firstname.lastname@example.org. You can also visit us at www.tessellate.com. For exciting updates and information, also check us out on our Facebook, LinkedIn, and Twitter page.
DST Health Solutions, LLC delivers contemporary healthcare technology and service solutions that enable its clients to thrive in a complex, rapidly evolving healthcare market. Supporting commercial, individual, and government-sponsored health plans, health insurance marketplaces, and healthcare providers, DST Health Solutions’ services include enterprise payer platforms, population health management analytics, care management, and business process outsourcing solutions, each designed to assist a company manage the processes, information, and products that directly impact quality outcomes. DST Health Solutions is a wholly-owned subsidiary of DST Systems, Inc. For more information visit www.dsthealthsolutions.com.
Dynamic Healthcare Systems, Inc. is a strategic business partner to healthcare organizations participating in government-regulated healthcare programs and is a certified third-party submitter with CMS. Dynamic’s comprehensive and fully integrated solutions address the following business areas of a healthcare organization’s operations:
- Risk adjustment (including RAPS, EDPS and HCC Analytics)
- HEDIS and quality measures
- Revenue reconciliation
- PDE management and audit
- Enrollment and eligibility processing
- Member premium billing
Inovalon is a leading technology company providing cloud-based platforms empowering a data-driven transformation from volume-based to value-based models throughout the healthcare industry. Through the Inovalon ONE™ Platform, Inovalon brings to the marketplace a national-scale capability to interconnect with the healthcare ecosystem on massive scale, aggregate and analyze data in petabyte volumes to arrive at sophisticated insights in real-time, drive impact wherever it is analytically identified best to intervene, and intuitively visualize data and information to inform business strategy and execution. Leveraging its platform, unparalleled proprietary data sets, and industry-leading subject matter expertise, Inovalon enables the assessment and improvement of clinical and quality outcomes and financial performance across the healthcare ecosystem. From health plans and provider organizations, to pharmaceutical, medical device, and diagnostics companies, Inovalon's unique achievement of value is delivered through the effective progression of “Turning Data into Insight, and Insight into Action®.” Providing technology that supports nearly 500 healthcare organizations, Inovalon's platforms are informed by data pertaining to more than 903,000 physicians, 385,000 clinical facilities, and more than 231 million Americans.
Signify Health partners with leading health plans, healthcare providers, and technology companies to improve quality of life by providing comprehensive care where and when it's needed most. With an innovative logistics and clinical workflow technology platform, exhaustive data set, and an unparalleled national clinical network, the company provides tech-enabled care services to vulnerable populations within the routine of their daily lives to improve health and quality of life. Signify Health serves well over one million health plan members each year, providing health risk evaluations, complex care management, and specialized medical services in the home and other convenient locations.
BeamMed is a developer and manufacturer of bone density assessment and monitoring solutions who has pioneered the early assessment of bone density, with the first – and still the only – devices that enable ultrasound-based, multi-site measurement for the early assessment and monitoring of osteoporosis. BeamMed’s Sunlight product line overcame the cost and radiation exposure-related challenges of Dual X-ray Absorption technology (DXA). As the only hand-held portable device, currently on the market, the MiniOmni offers high accuracy, small size, ease of use, reliability, excellent affordability, and radiation-free operation that can easily and safely be used in any doctor’s office, clinic, HMO, healthfairs, mobile medical vans, or retail venue such as pharmacies and checkup centers. HMO plans and providers rely on MiniOmni to screen more patients more often, to Close The Gaps and improve HEDIS OMW quality measures and achieve 5 Stars Maximization.
Cavo Health is setting the standard for fully automated medical coding utilizing new technology for fast accurate risk adjustment coding. We provide health plans and other risk adjusting organizations a tool that helps coding staff work more efficiently, find more HCC’s and improve speed of coding. Cavo Health’s technology deploys a proprietary precise matching engine instead of relying on fuzzy word associations of machine learning. We find the words that confirm the presence of a risk adjustable ICD in a medical record (EMR or PDF) and coders then verify the matches in seconds. Cavo Health works equally well as a First Pass or Second Pass auto-coding tool. Cavo Health can also reduce coding errors during a RADV audit, and even audit Claims data. Our coding tool complements your coders work, resulting in precise ICD identification with more HCCs confirmed, increase chart review productivity, greater accuracy and improve coding compliance. For more information on the Cavo Health difference, please contact Steve Butler at (630) 388-8220. Or visit us at www.cavohealth.com
Edifecs develops innovative, cost-cutting information technology solutions to transform the global healthcare marketplace. Since 1996, Edifecs technology has helped healthcare providers, insurers, pharmacy benefit management companies and other trading partners trim waste, reduce costs and increase revenues. More than 350 healthcare customers today use Edifecs solutions to simplify and unify financial and clinical transactions. In addition, Edifecs develops supply chain management solutions to support worldwide customers in non-healthcare industry segments. Edifecs is based in Bellevue, WA, with operations internationally. Learn more about us at www.edifecs.com.
FindACode.com delivers cutting-edge coding & reimbursement tools for anyone who deals with Professional, Facility, and/or Risk Adjustment (HCC) coding. Our intuitive and customizable interface puts your most important tools and reference materials at your fingertips, increasing productivity and efficiency at every level of revenue cycle. FindACode.com is cloud-based so - no installation/updates necessary, everything is always up to date and accessible from anywhere with internet access. Our 100% US-based support and technical teams provide the gold standard for quality and service without breaking the bank.Start your no obligation 28 days Free Trial today at www.findacode.com/trial!
GeBBS is a leading provider of medical coding service. With over 2000 employees and over 400 medical coders we provide our clients with the operational scalability that they need to be successful. Our facilities are ISO 27001 certified and SAS Type II audited. GeBBS is the single source for HCC Risk Adjustment services to Medicare Advantage health plans and their provider partners. The majority of our coders are CPC, CPC (H) or CCS certified. Our services include:
- HCC Risk Adjustment Coding
- Data Validation and RADV Support
- Record Retrieval and HEDIS Abstraction
As the leading consulting and software solutions firm specializing in government health programs, Gorman Health Group (GHG) combines innovation with proven, integrated approaches and technology solutions to help organizations operating in Medicare, Medicaid, and the Health Insurance Marketplace reduce costs, improve quality, and optimize revenues. Since 1996, GHG’s unparalleled teams of subject matter experts, former health plan executives, and seasoned healthcare regulators have been providing strategic, operational, financial, and clinical services to the industry across a full spectrum of business needs. Further, GHG’s software solutions have continued to place efficient and compliant operations within our clients’ reach.
GHG’s mission is to empower health plans and providers, through a compliant, member-centric focus, to deliver higher quality care to members at lower costs while serving as valued, trusted partners. Learn more at www.gormanhealthgroup.com.
HealPros exists to support health plans in closing critical gaps in care associated with diabetic retinal exams, as well as A1C, microalbumin, colorectal cancer, and bone density screenings. Recognizing that the biggest barrier to preventative screenings is logistical, HealPros launched the industry’s first fully mobile solution, bringing state-of-the-art DRE and test kits to the member’s home. Our innovative model has been proven to help health plans close non-compliant gaps in care that drive down HEDIS scores and STAR ratings.
HealPros is on a mission to improve quality of life and reduce the cost of care through better disease identification and management. Our solution makes it easy for members to complete a wide range of preventive screenings - by bringing care to their homes.
HealthCrowd is the industry's first end-to-end communications solution for payers. Our vision? To transform healthcare communications from tactical activity to strategic lever. The company's product suite comprises its flagship Unified Communications Platform, Clairvoyance(TM) for advanced campaign analytics, and HealthNeuron(TM) to comply with federal and industry regulations around digital member outreach. HealthCrowd helps health plans unify, automate and optimize multimodal communications to deliver member-centric engagement, at scale, in a risk-managed way. The impact is profound: A positive difference in members' perception of health plan communications and significant, quantifiable savings to the health plan.
Health Data Decisions provides strategic and analytic consulting related to quality, efficiency and population health. We help health plans, at-risk provider groups and analytics vendors to maximize the use of their data for predictive and retrospective measurement and modeling.
Our team brings decades of experience with measurements including HEDIS, Stars, QRS, AHRQ and P4P in management, analytics, and programming. We can manage your team, your vendors and your data to improve your HEDIS 2017 project. Talk to us about improving the value of your data and your overall measure rates.
Matrix Medical Network brings care directly to individuals in their homes through its clinical network of 4,000 providers spanning all 50 states. Matrix providers deliver innovative revenue, quality and care management services in support of the country’s leading health plans and at-risk provider organizations. Leveraging advanced analytics and leading-edge technologies, Matrix achieves unprecedented engagement of plan members and patients to improve quality of care and outcomes, while generating positive impact for healthcare payors. Matrix solutions include risk adjustment, quality gap closure, community and needs assessments, care management and post-acute support. Matrix supports populations of all ages from infants to seniors across all plan types including Medicare, Medicaid, Commercial and Exchange.
Mom’s Meals NourishCare provides high-quality meal solutions direct to the homes of senior’s and patient’s nationwide. Customers choose every meal every order from our broad selection of entrees, including those to support common health conditions. Mom’s Meals has been a leading nutrition provider for over 18 years.
Optum is a leading health services and innovation company dedicated to helping make the health system work better for everyone. With more than 124,000 people worldwide, Optum combines technology, data and expertise to improve the delivery, quality and efficiency of health care. Optum uniquely collaborates with all participants in health care, connecting them with a shared focus on creating a healthier world. Hospitals, doctors, pharmacies, employers, health plans, government agencies and life sciences companies rely on Optum services and solutions to solve their most complex challenges and meet the growing needs of the people and communities they serve.
PharmMD is a leading healthcare technology company providing data-driven medication adherence platform solutions that deliver value-based care outcomes. PharmMD partners with health plans, providers and other risk-bearing entities seeking to improve patient and employee healthcare through better medication adherence. Founded by healthcare and pharmaceutical innovators, PharmMD’s outcomes-driven solutions bolster initiatives in quality improvement and related regulatory compliance through better medication adherence. For more information, please visit www.pharmmd.com.
PopHealthCare offers innovative programs in complex population management that drive rapid, large, and demonstrable improvements in member quality of life and satisfaction, while helping its partnering health organizations to appropriately code and document members, enhance quality scores, and reduce medical costs. Our full suite of services, including health care analytics, field-based complex population care delivery, and comprehensive prospective and retrospective risk adjustment solutions, are focused on improving the lives of patients and helping them get the care they need – when and where they need it most.
Advantmed is an integrated risk adjustment optimization and quality improvement company dedicated to helping health plans and risk-bearing entities. Our ELEVATE! Healthcare™ platform delivers fully transparent insights for all of our solutions, which include:
- Medical Record Retrieval (Risk Adjustment/HEDIS®)
- Risk Adjustment Coding (MA/ACA/Medicaid)
- Clinical Abstraction (HEDIS)
- Risk Adjustment Suspecting & Targeting (MA/ACA)
- CMS & HHS RADV Support/Data Validation
- NCQA-Certified HEDIS Software (Measuring & Reporting)
- Health Risk Assessments (In-Home/In-Office)
The Healthcare Effectiveness Data and Information Set (HEDIS®) is a registered trademark of the National Committee for Quality Assurance (NCQA).
With close to 12,000 employees, Omega Healthcare is the leading provider of outsourced healthcare services. Omega’s solutions include the entire spectrum of revenue cycle, billing and medical coding services for providers and hospitals as well as specialized services for the payer community. As the demands within the Risk Adjustment departments increase, Omega leverages its 4000 plus coders to help its clients with HCC coding, provider scheduling, chart retrieval, retrospective chart reviews, RADV Audits and HEDIS Reviews. For more information on how Omega can help add value to your organization or to conduct a free assessment, contact Daphne Oberlander, Senior Vice President, 248-390-8144 email@example.com. www.omegahms.com
Centauri Health Solutions is a leading provider of technology-enabled analytics and services helping health plans and health systems to manage their variable revenue linked to population health (risk), quality, and eligibility factors. These efforts result directly in better-informed health care delivery, richer benefits, and reduced out-of-pocket healthcare costs for the members and patients they serve.
Whether dealing with HEDIS or Risk Adjustment, every chart is fiscally important. Datafied produces the highest completion rates in the industry and we have the data to prove it. We are able to achieve these rates by utilizing our network of EMRs, HIEs, provider portals, ROI vendors, and onsite scanning professionals. Our call centers are skilled at producing rapid turnaround time, which provides your plan the opportunity to complete 2nd and even 3rd HEDIS pursuits. Speedier results are also beneficial for Risk Adjustment projects as they provide new avenues of documentation. In addition, our provider database is constantly being updated with the most accurate information in order to provide time and cost savings when completing chases.
Your health plan must win. Let us make sure you do.
CareLinx is a nationwide professional caregiver marketplace, empowering families to easily find, hire, manage and pay licensed caregivers online. Our platform has more than 200,000 caregivers across the country. Hiring caregivers through CareLinx can save families as much as 50 percent than if they hired the same caregivers through brick and mortar franchise agencies. The CareLinx platform helps families and caregivers easily manage all the administrative tasks of their caregiving needs, including scheduling, time tracking, care coordination and payroll processing. CareLinx caregivers earn considerably higher wages than working through franchise agencies. Higher earning caregivers are more engaged and offer better quality care. All CareLinx caregivers hired by families are background checked and covered with $4 million in professional liability insurance.
NeuroMetrix is an innovative medical device company focused on the most costly and prevalent chronic complication of diabetes – diabetic neuropathy. NeuroMetrix markets the NC-stat® DPNCheck™ device, which is a rapid, accurate, and quantitative point-of-care test for diabetic neuropathy. Due to the limitations of traditional clinical detection methods such as monofilament testing, many organizations under diagnose diabetic neuropathy and unknowingly carry the risk of this costly and debilitating complication. Our technology helps Medicare Advantage organizations improve the accuracy of diabetic neuropathy detection, accurately risk assess their diabetes patients and optimize neuropathy and general diabetes treatment.
Nagnoi, LLC is specialized in Healthcare Analytics with solutions for Payers, Providers, and Public Health organizations. STARSTrack, our flagship product, is one of the most advanced analytics solutions providing state agencies and health plans the necessary visibility, agility, and up-to-date monitoring of quality measures. It was built to improve quality performance while reducing costs across the areas of Medicare (CMS’s Five Stars Rating Program), Medicaid (CMS’s 2390-F), and Commercial (QRS for QHP’s). In 2011, Nagnoi was awarded Worldwide Business Intelligence (BI) Company of the Year and, in 2013 and 2014, Health Partner of the Year, both by Microsoft Corporation. In 2012, Nagnoi was included in the Forrester Research BI Service Provider Shortlist. For more information, visit www.nagnoi.com.
Change Healthcare is inspiring a better healthcare system. Working alongside our customers and partners, we leverage our software and analytics, network solutions, and technology-enabled services to enable better patient care, choice, and outcomes at scale. As a key catalyst of a value-based healthcare system, we are accelerating the journey toward improved lives and healthier communities. Learn more at www.changehealthcare.com.
Welch Allyn is a leading medical diagnostic device company, and is a division of Hill-Rom (NYSE: HRC). At RISE we are featuring the RetinaVue™ Network—a proven turnkey diabetic retinopathy screening program made simple and affordable enough for individual primary-care practices and scalable for nationwide health-plan screening programs. RetinaVue can double DRE patient compliance rates in just 12 months to positively impact HEDIS scores and Medicare Star ratings on the DRE metric, and help preserve vision in patients with diabetes.
Babel Health offers the first integrated suite of risk adjustment submission applications (EDPS, RAPS, EDGE Server, Medicaid) for Government-sponsored programs. Our innovative solutions enable payers to increase revenue, reduce operating costs, meet compliance requirements, and improve quality in this complex, dynamic environment. Babel integrates seamlessly with existing IT applications to provide business users with unprecedented insight, control, and transparency. Our mission is to empower you to take control of your risk adjustment submissions, analytics, forecasting, and reconciliation. The result is less manual work, higher compliance, true insight, and optimized revenue.
Headquartered in Ann Arbor, Michigan, ATTAC Consulting Group (ACG) specializes in compliance solutions, auditing, business operations and process controls, for insurers and healthcare organizations. ACG focuses on the space between what’s supposed to happen on paper and what’s actually happening on the ground. Our firm assists our clients identify and resolve the difference.
ACG’s team of professionals is comprised of industry experts with extensive real-world, hands-on experience working in, and with, the organizations operating government health programs including: Medicare Advantage, PDP, Medicaid and Duals, Qualified Health Plans (QHPs), ACOs and provider groups. Our team focuses on institutionalizing compliance throughout health plan operations to enhance efficiency and return on investment.
ACG’s audit specialties include:
CMS Performance Audits, Data Validation Auditing, Third-Party Corrective Action Outcome Validation, CMS Financial Audit Preparation, First Tier, Downstream and Related Entity Monitoring and Auditing, QHP Compliance Auditing, Development of Internal Monitoring, Auditing and Process Controls
Elation Health strengthens the patient-physician relationship by providing a revolutionary, provider-centric platform that lets physicians focus on their patients and deliver high-quality care. Founded in 2010 by siblings, Kyna and Conan Fong, Elation’s “Clinical First” philosophy and intuitive design are trusted by thousands of clinicians. For more information, visit www.elationhealth.com.
ChartFast is an innovator in ROI automation, medical data analysis and presentation. We are dedicated to bringing cloud based medical record services to the healthcare industry. Our powerful platform provides Health Information Management (HIM) professionals with the ability to automate many of the Release of Information (ROI) processes currently performed manually. Our mission is to modernize the request process for health plans, healthcare providers and their patients.
TRACSCOUT automates the complex processes of UM and G &A. Robust automation, performed within an ecosystem of CMS-driven compliant workflows and expert, common-sense advice increases operational efficiency and improves audit readiness. Our processes and workflows have been field-tested and refined over time to improve operational efficiency and reduce the administrative burden for payers, providers and members. Our highly customizable platform reduces processing time, improves documentation and increases satisfaction. We bring the expertise, process AND technology.
Prognos is a healthcare AI company focused on eradicating disease by driving decisions earlier in healthcare in collaboration with payers, Life Sciences and diagnostics companies. The Prognos Registry is the largest source of clinical diagnostics information in 35 disease areas, with over 13B medical records for 180M patients. Prognos has 500 extensive proprietary and learning clinical algorithms to enable earlier patient identification for enhanced treatment decision-making, risk management and quality improvement. The company is supported by a $23M investment from Safeguard Scientifics, Inc. (NYSE:SFE) and Merck Global Health Innovation Fund (GHIF). For more information, visit www.prognos.ai.