Transcript Document
The Availity Health Information Network: Good for Health Plans, Capabilities and Connectivity ® good for Delivery Systems, Supporting and the Next good Generation for Patients Revenue Cycle Tomorrow’s Information Needs Migration to value-based programs and payment models demands: Inpatient Information • Admissions • Concurrent Review • Lab Results • Discharge Information Medical Attachments Clinical Summaries As well as expanded integration and connectivity with: • HIEs • Hospital/physician systems • Health plans Today’s Information Exchange largely consists of: EDI/HIPAA Transactions • Claims • Eligibility & Benefits • Claim Status • Remits Physician Self Service • Web portals • Real-time information • Care management tools Revenue Cycle Management • Advanced claims management for physicians and health plans Focus on Impact Impact Requires Provider Adoption Provider Adoption Requires Demonstrable Value and Simplicity Simplicity is Achieved via Workflow Integration Workflow Integration is Accelerated by Use of Standards Adherence to Standards Can Drive Impact Clinical Documentation Overview Health Plan The Availity Network HospitalsProviders MedicalClinical Attachments Data Clinical Summaries EMR Integration with Availity® CareProfile® Clinical Data Admission Concurrent Review Clinical Lab Results Data Discharge Information Medical Attachments Integrated Clinical Documentation Value Propositions Cost / Quality / Compliance Care Coordination Revenue Cycle Care Management PCMH / ACO Risk Management HEDIS / Stars Administrative Savings Inpatient Information Exchange Integrated Authorizations Displays Patient Acct #, Patient Name, Medical Record # Displays facility name, health plan Displays status of info Quick authorization Exports to .csv file Refresh screen Allows user to set filters by facility, date, auth status or health plan search Displays auth responses, ADT message data, user comments by patient Displays Patient Class, admit date, discharge date, diagnosis Integrated Discharges Medical Attachments Clinical Summaries for Care Managers Structured data CCDc32 • • EMRs Allscripts Provider NPI, Name, Group Name • Review of Systems • Assessment and Plan Patient Name, DOB, Member ID • Medications • Progress Note • Diagnoses • Consult Greenway • Procedure Codes (CPT, HCPCS) NextGen • Allergies • Date of Service • Chief Complaint • Problem List • HPI Athenahealth eClinicalworks Epic GE Healthcare MedPlus Vitera Availity CareProfile ® ® with EMR Integration Integrated Clinical Documentation Value Propositions Cost / Quality / Compliance Care Coordination Revenue Cycle Care Management PCMH / ACO Risk Management HEDIS / Stars Administrative Savings Good for Health Plans, good for Delivery Systems, and good for Patients The Availity Health Information Network: Capabilities and Connectivity ® Supporting the Next Generation Revenue Cycle Thank you [email protected]