Conduent’s Post

#interoperability #fhir #PayerProviderDataExchange #onyxhealth Payer-provider data exchange via Fast Healthcare Interoperability Resources (FHIR) involves the secure and standardized sharing of healthcare information between healthcare payers (insurance companies, government agencies) and healthcare providers (hospitals, clinics, physicians). This article focuses on the kay challenges and the FHIR Based strategy to streamline this data exchange. https://lnkd.in/gR7Fpa_m

#TaxTipTuesday: 💫 Utilize Tax-Advantaged Accounts: Take advantage of tax-advantaged accounts such as Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) to save on healthcare expenses with pre-tax dollars.

Unlock the power of medical expense accounts to maximize your healthcare savings! 🩺💰 Dive into our guide to understand the nuances of FSAs, HRAs, HSAs, and MSAs, and make informed decisions that benefit your financial health. #HealthcareSavings #FSAs #HRAs #HSAs #MSAs #FinancialWellness

For healthcare payers, modernizing technology is the key to efficiency, scalability and cost savings. See how one health plan worked with Cognizant to immediately improve operating efficiencies and lower costs by upgrading the systems, processes and software used in its BPaaS delivery model. #Healthcare #Payers #BPaaS #ValueBasedCare Cognizant https://cogniz.at/3vivSc4

Keeping pace with the data-driven healthcare market is difficult for payers with legacy systems, but the cost of replacement is prohibitive. See how a Business Process-as-a-Service delivery model can solve the problem. #Healthcare #Payers #Providers #BPaaS Cognizant https://cogniz.at/3TKcA7s

Prior authorization is a crucial healthcare process where medical treatments or procedures require approval before being carried out. This ensures patients receive proper care and providers follow correct procedures, but the process can be time-consuming and complex. #aws #awscloud #cloud #advanced300 #amazonhealthlake #healthcare #technicalhowto #aiml #healthlake #interoperability

🚨 Avoid the MIPS Penalty Nightmare: How I Rescued a Healthcare Practice from Financial Disaster! 🚨 Did you know failing to comply with MIPS reporting can result in a 9% reduction in Medicare claims? For many healthcare practices, this could mean losing tens of thousands of dollars annually. Recently, I helped a medium-sized multi-specialty healthcare practice overcome significant operational challenges related to MIPS, CCM, and RPM services. Here’s how I did it: 🌟 Client Profile: A diverse, patient-focused healthcare practice dedicated to delivering high-quality care. 🔍 Challenges Faced: MIPS Compliance: Lack of a systematic approach leading to missed metrics and potential penalties. CCM and RPM Compliance: Frequent CMS audits due to incorrect billing. Revenue Leakage: Inefficient billing and coding inaccuracies causing delayed reimbursements. 💡 Solutions Implemented: MIPS Reporting and Compliance: I developed strategies to verify data, measure performance, and submit quality measures to CMS, ensuring compliance and avoiding penalties. Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) Programs: These programs not only improved patient outcomes but also generated additional revenue through CMS reimbursements. Billing and Coding Optimization: Using advanced technology and skilled coders, I streamlined billing processes and improved coding accuracy, significantly reducing claim denials. Revenue Cycle Management: Proactive management identified and resolved issues, improving cash flow and reducing the days in accounts receivable. 📊 Key Performance Indicators (KPIs): MIPS Performance Score: Ensured compliance and maximized incentive payments. Patient Engagement Metrics: Measured satisfaction and health outcomes improvement. Billing Accuracy Rate: Tracked to reduce denials and increase reimbursements. Days in Accounts Receivable (AR): Reduced to enhance financial stability. Compliance Audit Results: Ensured adherence to CMS billing and reporting regulations. 🔥 Outcomes Achieved: Improved MIPS Performance: Successfully met reporting requirements, avoiding penalties and qualifying for incentive payments, saving the potential $45,000 loss. Enhanced Patient Engagement and Outcomes: Better satisfaction, managed chronic conditions, and reduced ER visits. Enhanced Revenue Capture: Reduced revenue loss and increased reimbursements, strengthening financial health. Resource Optimization: Redirected resources to core clinical tasks, improving practice efficiency and patient care. 🚀 Conclusion: My strategic interventions enabled the client to address critical challenges related to MIPS reporting and revenue cycle management. Additionally, the introduction of Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) expanded the client's services, leading to improved patient outcomes and increased revenue opportunities. #RCM #MIPS #Compliance #BillingOptimization #RevenueCycleManagement #HealthcareInnovation #MIPSCompliance

The findings of this publication, present 8 new roles within healthcare, listed as: information platforms data collection technology market intermediaries services for remote and on-demand healthcare augmented and virtual reality provider blockchain-based PHR cloud service provider and intelligent data analysis for healthcare provider. Value Proposition Transformation: “There is a shift from a reactive healthcare service to a proactive one, to really try to improve and foster your health and try to get healthier, prevent getting sick, instead of trying to get healthy again when you are sick." https://lnkd.in/dnkNktDp

Keeping pace with the data-driven healthcare market is difficult for payers with legacy systems, but the cost of replacement is prohibitive. See how a Business Process-as-a-Service delivery model can solve the problem. #Healthcare #Payers #Providers #BPaaS Cognizant https://cogniz.at/44ZX24V

Discover the transformative benefits of Mirra Health Care's integration with Bank Lockbox Services! From accelerated processing to enhanced accuracy, each feature contributes to an efficient and secure premium billing management system. Ready to upgrade your financial workflows? Read more in our blog: https://bit.ly/3TuKiyU . . . . . . . . #accuracy #transformation #financialinnovation #securetransactions #mhc #efficientbilling #streamlinedworkflow #enhancedsecurity #medicare #workflowautomation #workflowoptimization #efficientoperations #BankLockboxServices #billingsolutions #billingsoftware #financialefficiency #SecureProcessing #billingexperts #medicareadvantage #healthcare #cms #florida #paas #accelerateprogress