Advantasure is a health technology and business process services company that improves the performance of health plans and provider organizations in the delivery of government healthcare programs. Through a comprehensive portfolio of products and services, Advantasure enables clients to lower administrative costs, increase reimbursement accuracy and improve the quality of care for their members.
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.
Pulse8 is theonlyHealthcare Analytics and Technology Company delivering complete visibility into the efficacy of your Risk Adjustment, Quality, and Pharmacy Benefit Management programs. We enable health plans and providers to eliminate waste and achieve the greatest financial impact in the Medicare Advantage, Medicaid, and ACA Commercial markets as well as with Value-Based Payment models for Medicare. Our advanced analytic methodologies and flexible business intelligence tools offer real-time visibility into member behavior and provider performance. Pulse8’s Illumin8 Active Intelligence™ platform offers a suite of uniquely pragmatic solutions that are powered by ourpatent-pendingDynamic 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 firstname.lastname@example.org.
DataLink is the premier data aggregation, value-based performance management, provider enablement, and point-of-care partner to health plans, MSOs, ACOs, IPAs, medical groups, and provider entities. DataLink aggregates disparate data sources and systems to create the one source of truth for clients. DataLink illuminates value-based contract performance, MLR impact opportunities, provider network alignment and engagement, care pathways, quality scores, and risk adjustment program excellence.
Improving healthcare outcomes requires access to the right data at the right time. Apixio is advancing value-based care with data-driven intelligence and analytics. Our AI solutions for risk, quality, and clinical insights unlock actionable information from administrative data and unstructured clinical information. The results drive better clinical decision-making and a smarter approach to healthcare. Learn more at www.apixio.com.
Inovalon is a technology company providing cloud-based platforms empowering data-driven healthcare. Through the Inovalon ONE® Platform, Inovalon brings to the marketplace a national-scale capability to interconnect with the healthcare ecosystem, aggregate and analyze data in real-time, and empower the application of resulting insights to drive meaningful impact at the point of care. Leveraging its platform, proprietary data sets, and subject matter expertise, Inovalon enables the improvement of care, efficiency, and financial performance across the healthcare ecosystem. From health plans and provider organizations, to life science and pharmaceutical companies, Inovalon's achievement of value is delivered through the effective progression of “Turning Data into Insight, and Insight into Action®.” Supporting thousands of clients, including 24 of the largest 25 U.S. health plans and 22 of the largest 25 global pharma companies, Inovalon's technology platforms and analytics are informed by data pertaining to more than 964,000 physicians, 519,000 clinical facilities, 264 million Americans, and 42 billion medical events. For more information, visit www.inovalon.com.
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
Cognisightis a leading health care solutions vendor, specializing in risk adjustment services for Medicare Advantage plans, Health Insurance Exchange issuers, PACE/Duals programs, Medicaid Managed Care plans, Accountable Care Organizations, and Independent Practice Associations. We understand all sides of the risk adjustment equation and provide our services to issuers throughout the United States. Our mission is simple: capture the most accurate and complete diagnostic information to help ensure our clients have the best information to care for their members. As risk adjustment experts, we enable our clients to improve the quality of health care they deliver while assuring accurate revenue.
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
PDE management and audit
Enrollment and eligibility processing
Member premium billing
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.
Bloom is a dynamic insurance services company focused on increasing membership and early data collection while reducing costs for insurance plans. Whether engaging in sales or customer service campaigns, Bloom’s mission is to provide an excellent experience for the member based on industry best practices. With almost three dozen insurance carrier clients and a strong investment in technology, we have a turnkey operation and management infrastructure that can execute seamlessly, it is as if we were part of your organization. Learn more at www.BloomInsurance.com.
Cognizant (Nasdaq-100: CTSH) is one of the world’s leading professional services companies, transforming clients’ business, operating and technology models for the digital era. Our unique industry-based, consultative approach helps clients envision, build and run more innovative and efficient businesses. Headquartered in the U.S., Cognizant is ranked 195 on the Fortune 500 and is consistently listed among the most admired companies in the world. Learn how Cognizant helps clients lead with digital at www.cognizant.com or follow us @Cognizant.
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.
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.
Pareto Intelligence is an analytics and technology solutions company that supports healthcare plans and providers with revenue, cost, quality, and risk adjustment payment models. Pareto was forged to help our clients navigate the most dynamic and critical times in healthcare, and we continue to bring innovative solutions to meet unmet market needs.
Pareto acts as a trusted partner, helping clients make key decisions with big data analytics, easy-to-use technology, and expert advisory support. Our award winning suite of technology solutions and services help our clients harness the power of data science and develop actionable insights. We show you what to do with the insights you’ve acquired and give you direction for tomorrow.
Pareto Intelligence was launched by HealthScape Advisors, a management consulting firm with decades of experience in the business of healthcare.
AdhereHealth™ is a healthcare technology solutions leader supporting health plans, self-insured employers and other risk-bearing entities for medication adherence insights and improved healthcare outcomes. The company’s Adhere™ platform touches nearly 10 million consumers through advanced technologies, at-risk engagement services and home-delivered pharmacy. The integrated set of solutions address an estimated $300 billion of unnecessary annual medical costs attributed to medication adherence issues. The company is headquartered in the Nashville suburb of Brentwood, Tennessee. For more information, please visit www.adherehealth.com.
Hallmark Business Connections helps businesses thrive by building and strengthening relationships with customers and employees. Enabled by technology and software for functional ease, these B2B solutions leverage gift cards and Hallmark greeting cards as emotionally impactful touch points.
As a subsidiary of Hallmark Cards, Inc., Hallmark Business Connections is headquartered in Minneapolis with offices in Kansas City and Duluth. For more information about customer and employee engagement solutions, visit HallmarkBusinessConnections.com.
Matrix Medical Network brings care directly to individuals in home, mobile, and facility settings across the country through its clinical network of over 6,000 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, advanced diagnostic testing, 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.
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.
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.
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.
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 To learn more about our highly efficient HCC Coding services, please contact Gini Nathani at 201-282-6181 and email@example.com or visit www.gebbs.com.
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.
Since 2004, Advanced Plan for Health’s advanced & predictive analytics platform, Poindexter, has delivered cost-saving insights and actions to help health plans, employers, providers, TPAs and others to identify and address areas of highest health cost and risk within their populations. More than 250 clients (and their over 2.5M members) rely on APH to simplify big data (enrollment, medical and pharmacy claims, labs, biometrics, HRAs, etc) to support actions that achieve measurable results. Phenotype predictive analytics show predicted medical and pharmacy costs and events like ER, Inpatient Admits, heart attacks and more. Learn more at www.mypoindexter.com.
HealthTrio, a leading Software-as-a-Service provider for the healthcare market, is dedicated to web-based solutions that improve experiences in value-based care, data integration, care coordination, and member and provider engagement. As the first to market a portal solution nearly twenty years ago, HealthTrio has been a longstanding leader in building elegant, advanced solutions, all purposefully designed to help simplify the intricate healthcare landscape.
Drawing together systems and stakeholders across the care continuum, HealthTrio partners with Medicaid, Medicare, Commercial and provider-sponsored customers to deliver robust, modular solutions that increase transparency, communication and collaboration. HealthTrio’s innovative technology solutions decrease costs while increasing access, supporting care and improving outcomes.
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 firstname.lastname@example.org. www.omegahms.com
QMetrics is a managed health care independent audit and consultancy group offering expert consulting services to health plans, provider groups, and MSOs in quality reporting, HEDIS® and STARS auditing and score improvement, data validation, risk score analysis, predictive modeling, regulatory compliance, survey fielding, and other related areas impacting managed health care organizations. Our knowledge and experience cover all aspects of risk adjustment including enhancing data completeness, advanced predictive modeling, and evaluating the efficacy of risk score improvement initiatives.
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.
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
Downstream and Related Entity Monitoring and Auditing
QHP Compliance Auditing
Development of Internal Monitoring
Auditing and Process Controls
Medical Advantage Group, a wholly owned subsidiary of The Doctors Company, is an innovator in maximizing health plan and physician clinical and financial performance in value-based contracting. With 20 years of experience managing cost and quality for physician practices, our hands-on approach drives change and positive returns on investment. Through collaboration and guidance, we provide practices and organizations of all sizes with customized, actionable solutions to decrease the cost of care and improve quality.
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.
Connect America’s mission is to help you better serve your members, with industry-leading Connected Health Solutions that can reduce ER visits and hospitalization rates, improve outcomes and lower utilization costs.
We are the nation’s largest independent remote patient monitoring company. We have regional offices throughout the U.S., partner with more than 1000 healthcare organizations and monitor more than 375,000 lives daily. Our solutions include; Personal Emergency Response Systems, Remote Patient Monitoring Solutions and Medication Adherence.
Cozeva is the operating system for value-based care and powers the transition toward a value-based ecosystem for quality, risk and cost performance. As a cloud-based operating system for ACOs, IPAs, payers, providers, and patients, Cozeva aggregates multiple data streams and turns them into actionable analytics and registry driven dashboards in real-time. Cozeva supports multiple stakeholders as they work together to fulfill their goals for MACRA, ACO, APMs, MIPS, Stars, HEDIS, P4P and HCC.
Advantmed is a healthcare solutions company, dedicated to partnering with risk-bearing entities. The ELEVATE! technology-enabled platform integrates Advantmed’s risk adjustment and quality services to deliver fully transparent insights for: