Advancing the Revenue Cycle toward a Denial-Free Future

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Imagine a revenue cycle so seamlessly interconnected that no claim is ever denied. Advancing the revenue cycle requires a new vision focused not on managing denials, but on preventing them from happening. Start your journey by learning the characteristics needed to make this vision a reality with our free e-book.

The e-book includes tips you can implement right now to improve your operations on topics including: 

·        CDI
·        Medical necessity
·        Coding
·        Claims integrity
·        Claims processing
·        Denials management
·        Payer appeals
·        Patient estimating
·        Eligibility verification

Healthix Improves Care Coordination with healthShare & Real-Time Clinical Alerts

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In every healthcare system, there is a profound tension between the need to protect the privacy of personal health information and the need to share it for better care. In New York State, health information exchanges such as Healthix, in the greater New York City area, must have written consent from patients before clinicians can access their information. Providers or facilities that share data with Healthix usually obtain consent during a patient’s visit. But what happens when the patient is admitted to an emergency department where he has not signed a Healthix consent form, and is unable to? What happens if he cannot convey critical information about his heart condition, for example?

The Healthix Essential Alerts program helps providers coordinate and deliver the best care while remaining compliant with privacy regulations. Healthix (the largest public health information exchange in the U.S.) uses InterSystems HealthShare® to gather and maintain a unified health record for more than 16 million individuals, share data with more than 600 healthcare organizations, connect more than 6,000 sites, and send more than 7 million Clinical Event Alerts per year to providers. InterSystems technology enables Healthix to continue improving care coordination and patient safety, while complying with privacy regulations.

To learn more, download the latest whitepaper today!

5 Strategies for Consolidating Clinical and Non-Clinical Payments

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Unifying clinical and non-clinical payments is one of the great challenges hampering administrative efficiency and optimization of the patient financial experience. Is it time for your healthcare system to consider payment consolidation? Our white paper helps you understand why it is important to the overall customer and staff experience, and offers strategies from knowledgeable healthcare professionals.

Redefining Acute Behavioral Healthcare

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This year, over four million people in the U.S. with behavioral health conditions — psychiatric, substance-related, or both — will enter an emergency department (ED) that is not prepared to properly treat them. This gap in care is causing widespread suffering while undermining the economics of our EDs.

ED teams know precisely what steps to follow when dealing with physical emergencies, but all too often that’s not the case with behavioral health emergencies. Most ED personnel are not sufficiently trained to effectively care with patients with behavioral health conditions.

In this paper, you will learn how an integrated approach to emergency psychiatric care empowers EDs to properly evaluate and treat behavioral health patients from the moment they enter the ED through discharge. Among the many benefits of this care model are:
•    Improved ED clinical quality
•    Increased hospital profitability
•    Optimized workflows and increased staff engagement
•    Greater community and patient trust

Is your provider organization maximizing its performance in value-based care programs?

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Over the past few years, there has been a significant increase in value-based care programs offered by health plans and government payers including accountable care organizations, bundled payment programs, pay-for-performance and quality improvement programs.  These programs often include a multitude of measures related to costs, quality, patient experience, and outcomes, along with sometimes complex methodologies to determine success.

Given the increasing financial impact associated with these programs, it is important for providers to understand the program’s intricacies as well as the analytical, operational, and clinical requirements to ensure its success.  This paper discusses how success with these programs is possible.

A Billion Data Points for Innovations in Care and Care Coordination

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Northwell Health, based on Long Island, New York, is one of the largest private health systems in the United States. Northwell uses InterSystems HealthShare to take a “bimodal” approach to innovation. This approach ensures that Northwell’s mission-critical EMR systems remain up, stable, and secure, while HealthShare’s unified health record captures their data in real-time for use in other, value-added applications.

Northwell initially used HealthShare to improve care coordination for women in high-risk pregnancies. The organization then used it as the foundation for a rule-based care management application that identifies high-risk patients, assesses needs, shares care plans across providers and locations, supports efficient workflows, and provides quality metrics for continuous improvement.

Now, through its Center for Health Information Technology and Innovation, Northwell uses HealthShare to develop new systems that:
• Target gaps in clinical workflows not typically covered by EMRs
• Simplify management of risk in at-risk contracts
• Automate establishment of patient cohorts for population health management and cohort analytics

Download this free case study now to uncover how Northwell achieved their goals of care quality, patient satisfaction, and business performance without having to disrupt the familiar workflows of existing EMRs and other clinical systems.