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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.
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:
• Medical Record Retrieval (Risk Adjustment/HEDIS®)
• Risk Adjustment Coding (MA/ACA/Medicaid)
• Risk Adjustment Suspecting & Targeting (MA/ACA)
• Claims & Data Validation
• Clinical Abstraction (HEDIS)
• HEDIS & ACO Submission
• NCQA-Certified HEDIS Software (Measuring & Reporting)
• Prospective Health Assessments (In-Home/In-Office)
• Physician Record Review
• Member Engagement & Outreach
• Provider Education
To learn more about Advantmed, visit us online at www.advantmed.com.
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.
Baker Tilly is a full-service management and technology consulting firm focused on delivering high-value healthcare solutions. Our Healthcare Consulting team combines nimbleness with sharp, practical recommendations and technical acumen focused on the following key transformational challenges facing our clients:
In addition to our primary areas of focus, we also help our clients achieve success in a number of other areas critical to healthcare transformation, including:
We work with our health plan clients to help them build the right mix of processes and technology to create real consumer-centricity.
To learn more please visit www.bakertilly.com/healthcare or contact Sarah Rittman at Sarah.Rittman@bakertilly.com or (919) 924-4455.
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.
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.
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.
Following the Verscend-Cotiviti combination, Cotiviti will be a leading information technology and analytics company that is reshaping the economics of healthcare, helping its clients uncover new opportunities to unlock value. Cotiviti’s solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher performing payment accuracy, quality improvement, risk adjustment, and network performance management programs. The company also supports retail and life/legal industries with data management and audit services that improve business outcomes. For more information, visit www.cotiviti.com.
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.
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
Epstein Becker Green has served as a thought leader in the health care industry for more than 40 years. This sustained focus allows us to bring decades of experience to the managed care industry by counseling clients on complex regulatory matters concerning governmental programs such as Medicaid and Medicare. We bring a seasoned perspective to Medicare Part C contractors regarding recent risk adjustment enforcement and have successfully guided clients through government investigations, disclosures and compliance matters.
FTI Consulting Health Solutions works closely with payers, providers and other healthcare enterprises to anticipate challenges, identify areas for potential growth and operationalize changes. We provide unparalleled expertise, analytics, innovation, and the necessary global reach to achieve success.
FTI can help you optimize performance in the short term and prepare for the inevitable strategic, operational, regulatory and financial challenges of the future.
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:
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.
HealthMine is a Health Action as a Service (HAaaS) company that accelerates individual health improvement and profitability through advanced analytics, prioritized clinical pathways, and member engagement. Originally built inside a Value-Based Insurance Design (VBID) health plan, HealthMine’s services help health plans target and empower individuals to take health actions that improve clinical outcomes, while decreasing care costs and increasing plan revenue.
HealthMine’s Health Action Services consist of three solution-based platforms:
HealthMine is based in Dallas. For more information, visit www.healthmine.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.
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.
Since 1990, MedXM has been a national leader in the design and implementation of preventive care technology and in-home health risk assessments for the purpose of care management, quality improvement, and member engagement. MedXM offers a complete network of connections between members, their health plan, and providers. MedXM is focused on delivering Risk Adjustment and Quality Solutions by providing clients with fully customizable healthcare solutions to fulfill specific needs. MEDXM can help develop and implement your preventive care management strategy to help your plan reach better financial and quality outcomes.
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.
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.
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 firstname.lastname@example.org. You can also visit us at http://www.Pulse8.com, and follow us on Twitter @Pulse8News.
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.
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.
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.
Cognisight is 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.
Full suite of risk adjustment services:
Provider & Coder Training
(877) 271-1657 | Cognisight.com | info@Cognisight.com
Convey Health Solutions is a specialized healthcare technology and services company that is committed to providing clients with healthcare-specific, compliant member support solutions utilizing technology, engagement, and analytics. The company’s administrative solutions for government-sponsored health plans help to optimize member interactions, ensure compliance, and support end-to-end Medicare processes. By combining its best-in-class, built-for-purpose technology platforms with dedicated and flexible business process solutions, Convey Health Solutions creates better business results and better healthcare consumer experiences on behalf of business customers and partners. The company’s clients include some of the nation’s leading health insurance plans and pharmacy benefit management firms. Their healthcare-focused teams help several million Americans each year to navigate the complex Medicare Advantage and Part D landscape.
To learn more please visit www.ConveyHealthSolutions.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:
Evolent Health partners with leading health systems to drive value-based care transformation. By providing clinical, analytical and financial capabilities, Evolent helps physicians and health systems achieve superior quality and cost results. Evolent’s approach breaks down barriers, aligns incentives and powers a new model of care delivery resulting in meaningful alignment between providers, payers, physicians and patients.
Geneia LLC is an analytic solutions and services company that helps our clients improve outcomes, lower costs, and restore the Joy of Medicine to physician practice. Our team of physicians, nurses, technologists, analytics experts, and business professionals have created a suite of clinical and analytic solutions that enable health plans, hospitals, and employers to better understand, evaluate, and manage the health of their populations. The company has offices in Harrisburg, PA and Manchester, NH.
Hyperlift helps organizations improve their Star ratings. Our solutions enable a technology-led approach to Stars management that reduces uncertainty and delivers immediate results for all Stars teams. Regardless of size. Regardless of performance. Hyperlift’s Stars Management Suite (SMS) and Deliverables as a Service (DaaS) combine to offer an end-to-end Stars management solution made up of three core components: Measure Assessment, Performance Improvement, and Year-Round Management. Our suite of technology solutions makes a comprehensive, year-round approach to Stars management possible without significant internal resource requirements. Hyperlift’s process drives immediate impact by providing the right information at the right time. Reduce risk. Improve results.
Peerfit Move is a proactive approach to wellness for Medicare Advantage members, providing flexible fitness options and facilitating social connections to maintain an active lifestyle.
SAS analytics empower healthcare organizations to make better decisions that improve outcomes, create financial gains and generate positive consumer experiences. SAS’ transparency encourages customers to unlock value from their data. Our customers eliminate siloes in their organizations, producing actionable insights to better know, engage and manage their populations.
Using advanced analytical techniques, SAS has enabled customers to:
• Utilize machine learning techniques for enhancing risk adjustment initiatives
• Identify the right populations to engage and move the needle on quality metrics
• Combat the opioid epidemic in partnership with payers, providers & government entities
SAS is the leader in analytics. Through innovative analytics, business intelligence and data management software and services, SAS helps customers at more than 83,000 sites make better decisions faster. Since 1976, SAS has been giving customers around the world THE POWER TO KNOW®. SAS is committed to helping health care organizations make better decisions. Learn more at sas.com/healthinsurance.
The QuantaFlo™ System from Semler Scientific is a fast, simple and accurate test for primary care and other providers to find and document Peripheral Arterial Disease (PAD) to improve clinical care and HCC coding accuracy. The QuantaFlo system is currently in use at hospitals, clinics and physician offices throughout the country. Semler Scientific, Inc. is an emerging medical risk-assessment company whose diagnostic and testing products and services help to guide patient care and close the gap between cost of care and compensation for care.
Visionary is a pioneer in the offshore Risk Adjustment coding solutions since 2008 and has the world’s largest market share for offshore risk adjustment coding volumes for Medicare and Commercial markets. With the largest health plans and healthcare organizations as clients, Visionary aims to deliver the highest standard of coding accuracy and the maximum client satisfaction. Visionary offers unparalleled scale, flexibility and reliability for the very time bound and unpredictable volumes for the CMS submission
Some leading highlights of our accomplishment are listed below
Ankura is a business advisory and expert services firm defined by HOW we solve challenges. Whether a client is facing an immediate business challenge, trying to increase the value of their company or protect against future risks, Ankura develops and executes tailored solutions by assembling the right combination of expertise. This gives our clients unparalleled insight and experience across a wide range of economic, governance, and regulatory challenges. At Ankura, we know that collaboration drives results.
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
Aviacode is an industry leader in medical coding and coding audit services, which has been meeting the needs for physician groups, hospitals, and payers for nearly 20 years. Our certified coders are experienced in facility, pro-fee, and HCC/risk adjustment coding for a wide range of specialties. At Aviacode, our goal is to find a better way to optimize reimbursements -- building medical coding solutions that improve coding accuracy, reduce risk, and maximize revenue efficiency.
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.
Bloom is a dynamic insurance services company that creates specifically engineered solutions supporting the Insurance industry. We are focused on increasing membership and early data collection while reducing costs for Insurance plans. Whether engaging in sales or customer service campaigns, Bloom strives to provide an excellent experience for the caller based on industry best practices. We have submitted over $6 billion in premium and have participated in over 72 million conversations about Insurance since our inception in 2007.
Bloom currently operates two call center facilities in Bloomington, Indiana and is opening a third facility to be located in Phoenix, Arizona in 2016. We are privately owned and currently have around 700 employees.
With nearly three dozen insurance carrier clients and an investment in technology available only at Bloom, we have a turnkey operation and management infrastructure that is capable of executing so seamlessly, it is as if we were part of your organization.
Backed by the power of 180+ million lives, Blue Health Intelligence (BHI) is the premier resource for data-driven healthcare insights. By leveraging greater accuracy and transparency, BHI’s Population Advyzer delivers a 12:1 ROI for our ACA and MA risk adjustment clients. We also help health plans continually measure program performance and achieve greater internal control of their analytics. At BHI, our only risk adjustment incentives are to help plans improve results and reduce wasteful interventions
For nearly 30 years, Carenet Healthcare Services has provided solutions that simplify healthcare experiences while influencing millions of consumers to make better health choices. The company has a proven track record of measurably improving the quality and lowering the cost of healthcare for 80+ clients. Award-winning solutions include Strategic Engagement, Clinical Activation, and Healthcare Advocacy and Navigation, which support ER avoidance, closing gaps in care, admission and readmission reduction, pharmacy-related cost savings and more.
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
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 providersand their patients.
ChipRewards brings together behavioral science and cutting-edge technology to provide a dynamically configurable platform to optimize engagement in targeted behaviors to meet specific goals, KPIs, and organizational needs. The ChipRewards ecosystem allows you to create an engagement hub, performance analytics, personalized communications, reward and incentive program and much more.
CitiusTech, recognized by 2017 HCI 100, is a provider of healthcare technology services & solutions to health plans, medical technology companies, providers, & life sciences organizations, with over 2,900 healthcare IT professionals worldwide and serving over 80+ healthcare organizations globally. CitiusTech offers services around integration and interoperability, data management, performance management and data analytics. CitiusTech helps customers accelerate innovation in healthcare with solutions across quality reporting, big data, cloud, mobile & predictive analytics.
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 innova¬tive 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.
CoverMyMeds is dedicated to helping patients get the medications they need to live healthy lives, and is focused on developing solutions that empower better decision support at the point of prescribing and ultimately enable patients to be more involved in their health care coordination plans. CoverMyMeds’ network includes more than 500 electronic health record systems (EHRs), 62,000 pharmacies, 700,000 providers and most health plans and PBMs.
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.
Datafied produces the highest completion rates in the industry and we have the data to prove it. We accomplish this through a network of EMRs, HIEs, provider portals, ROI vendors and onsite scanning professionals. Our call centers are skilled at producing rapid turnaround time, providing you with time for 2nd and even 3rd HEDIS pursuits. Speedier results for risk projects similarly provide new avenues of documentation. In addition, our provider database is constantly updated to help avoid spending money on fruitless chases.
Your health plan must win. Let us make sure you do.
Diameter Health empowers health plans to unlock the full potential and value of clinical data by normalizing, cleansing, deduplicating and enriching clinical data from any certified electronic health record (EHR). With technology certified by the National Committee for Quality Assurance (NCQA) and the Office of the National Coordinator (ONC), Diameter Health produces standard, supplemental clinical data for use in HEDIS reporting. For more information, visit http://www.diameterhealth.com or email email@example.com.
Discovery Health Partners offers payment and revenue integrity solutions that help health payers improve revenue, avoid costs, and enhance the member experience. We offer a unique combination of deep healthcare expertise and analytics-powered technology solutions to help our clients improve operational efficiency, achieve financial integrity, and generate measurable results.
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.
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.
Eliza, an HMS Company gets modern healthcare consumers to act by engaging them in personalized conversations at enterprise scale. Your top priorities have never been clearer: improved quality, better cost management, incremental revenue generation, and a better consumer experience. The Eliza Health Engagement Management solution integrates a scalable multi-channel technology platform, proprietary data sources, industry leading analytics, and experience-driven program design to help clients achieve outcomes that make a difference.
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!
Focus Care Inc.
One of the leading causes of hospital read missions is lack of proper nutrition. GA Foods is proud to bring meals directly to your members’ home, adding that extra set of “eyes and ears” to confirm their well-being. For over 40 years, we have been the leader in supporting healthy and independent aging in the elderly population with our nutritious home-delivered meals.
Our registered dietitians and executive chef plan every meal to meet federal and state guidelines, while also being suitable individuals managing diabetes and cardiac conditions. Visit our booth and learn how to reduce admissions while providing extra member care!
GuideWell Connect is a leader in integrated consumer engagement solutions that helps health plans attract, engage and retain members. GuideWell Connect provides technology-enabled services across the member lifecycle to grow membership, drive better health outcomes, and advance health plans’ financial performance. Learn more at www.guidewellconnect.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.
Healow Insights is an innovative, cloud-based solution with service offerings designed to automate the bidirectional exchange of actionable data between health plans and providers. Our on-demand services offer a 360-degree view of all available member data in a way that benefits both health plans and providers. By providing timely access to comprehensive, reliable and actionable data, we help health plans reduce their overhead costs, improve compliance and boost ratings. Experience the Healow Insights difference today!
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.
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.
Health Data Vision, Inc. is a healthcare technology company empowering managed care organizations to take control of their Risk Adjustment and Quality Improvement initiatives to improve quality of care and overall revenue performance. Our client solutions are delivered through our powerful and transparent MRCS platform. We serve Medicare, Commercial ACA and Medicaid plans nationwide utilizing services such as:
Connect with us at www.healthdatavision.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.
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.
Home Access Health seeks to empower members to take the first step in managing their health using our pioneering at-home laboratory testing service. Our unique kit design makes sample collection easy, which increases program compliance. As a result, your plan receives the data needed to improve quality measures and manage risk. Members win too; they get a picture of their health and a connection to a primary care physician. Our tests include A1c, microalbumin, cholesterol and colorectal cancer. To learn more please visit www.homeaccess.com
Insightin Health provides a member engagement & data aggregation platform for the complete healthcare life-cycle. By centralizing all data points around the member, including communication response and social determinants of health, our AI-driven platform empowers Health Plans to increase acquisition, minimize churn, and improve measure adherence. Through rule-based decision functionality, end-to-end campaign automation, and machine learning for predictive analytics, our clients are able to generate a positive ROI while creating a truly personalized member experience.
Interpreta optimizes quality of care, risk adjustment, member prioritization, and precision medicine in real-time. By continuously interpreting clinical and genomic data, Interpreta creates a dynamic, shared, and personalized roadmap for physicians, patients, and key stakeholders. Interpreta integrates many applications to enable real-time population management.
ionHealthcare® is a nationally renowned partner for health plans, ACO’s, physician practices, hospitals, and individual coders. ionHealthcare® is a national leader in the risk adjustment industry offering risk adjustment education for coders and physicians as well as medical coding review for risk adjustment to include CMS HCC, Medicaid CDPS, and HHS HCC models in addition to predictive analytics support. Services for auditing include internal and external coding audit and RADV/IVA services. Our CEO is the author of the official CRC© (Certified Risk Adjustment Coder) curriculum and credential that is nationally offered through the AAPC. Our coders are all on-shore and highly trained in risk adjustment, and have assisted with concurrent, retrospective, and prospective projects as well as auditing work to include RADV experience.
ionHealthcare® also provides affordable online courses (many carry CEU value) and in-person training for coders and providers on many subjects to include HIPAA, Ethics, ICD-10-CM, Fraud, Waste & Abuse, and more. Contact us at www.ionHealthcare.com for more information or to inquire about customized solutions.
ionHealthcare® also offers consultations for physician practice efficiency, management, leadership mentoring, change management, patient safety, JCAHO, and OSHA support.
Judge Healthcare is a leader in providing customized clinical workforce solutions to healthcare organizations throughout the country. With engagements in almost 50 states, we currently have clinicians working as far away as Hawaii, Puerto Rico and St. Thomas and as remote as Indian Reservations in New Mexico. Judge Healthcare delivers the highest quality healthcare professionals for executive search, physician recruitment, contract/temp, contract-to-hire, per diem/travel/locum tenens, in-home/facility assessments, and on-going case management opportunities across the healthcare spectrum. Ranked the 20th Largest Allied Healthcare Staffing Provider in the US by Staffing Industry Analyst. Judge Healthcare has Delivery Centers in Philadelphia, PA, Atlanta, GA, Portland, OR, Minneapolis, MN, Washington, D.C., Los Angeles, CA, Dallas, TX, Las Vegas, NV and Kansas City, MO. To learn more, visit judge.com or contact 1-800-650-0035.
We are a small business serving the healthcare industry. Our expertise is working with health plans and managed care organizations in commercial, Medicaid and Medicare programs, pharmacy benefit management companies, and federal and state agencies.
Our diverse team has experience in these six areas:
A pioneer in healthcare analytics, MedeAnalytics helps organizations make even smarter decisions. With the most advanced data orchestration in healthcare, our intelligent cloud-based analytics platform combines data to deliver state-of-the-art analytics, all in a business context. Learn more at www.medeanalytics.com.
MARSI, an established document and coding audit company since 1991 has an excellent reputation and track record. MARSI has been innovative in developing processes at least five years ahead of our competitors, such as: pre-billing auditing, comprehensive review compliance and physician documentation improvement . . . that actually works.
MiraMed partners with hospitals, health networks, physician practices and related industry service organizations to provide a broad portfolio of customizable solutions to uncover and capitalize on hidden financial opportunities, improve productivity and ultimately increase profits.
The key to MiraMed's success is its unique business model that has evolved over the last 35 years. Under this model, MiraMed pairs healthcare industry experts with world-class processes, infrastructure and technology to deliver superior results. This proprietary model enables sustainable outcomes by delivering customizable enhanced revenue cycle management solutions devised to meet a client's own unique financial and organizational needs.
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 nearly 20 years.
Moxe Health is an automated clinical data clearinghouse, focused on accelerating the exchange of clinical data from all corners of the healthcare ecosystem.
We deliver automated Chart Retrieval through Substrate, an EMR integration platform, performing the real-time exchange of clinical, analytic, and administrative data between health systems and their network of health plans. Chart Retrieval provides health plans immediate access to complete, machine-readable medical charts that can be used for risk adjustment, HEDIS, and more. Convergence, our framework for embedding information from health plans directly within EMR workflows (single sign on, no portals!), displays insights about gaps in HCC documentation to clinicians at the point of care, where these insights can be acted upon.
Moxe facilitates access to the information required to succeed in the market shift to value-based care. We are the trusted broker to help data do what data does best: inform, enlighten, and make a difference.
mPulse Mobile, the leader in Conversational AI solutions for the healthcare industry, drives improved health outcomes and business efficiencies by engaging individuals with tailored and meaningful dialogue. mPulse Mobile combines behavioral science, analytics and industry expertise that helps healthcare organizations activate their consumers to adopt healthy behaviors.
With over a decade of experience, 70+ healthcare customers and more than 150 million conversations annually, mPulse Mobile has the data, the expertise and the solutions to drive healthy behavior change.
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.
Hearing loss can be overwhelming. But we believe that life is meant to be heard, and
the best way we can make a difference is to be there for you every step of the way.
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.
NovuHealth is the health care industry’s leading consumer engagement company. Combining performance analytics, behavior science and comprehensive technology solutions, our rewards and engagement programs enable health plans to increase high-value member activities—improving member health and driving plan performance.
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
Healthcare data is complex. We make it simple. Pareto Intelligence is your strategic partner that delivers technology, analytics and advisory solutions to improve value-based outcomes. We harmonize complex healthcare data to help health plans and providers achieve complete and accurate revenue, communicate critical patient information seamlessly, and make more informed strategic decisions. Our solutions are delivered on our HITRUST-certified platform, powered by advanced technologies, infrastructure best practices and proprietary data science. The result? Creative strategies to solve your organization’s most complex business problems.
Our newest solution, Pareto Engage, has modernized the way health plans and providers communicate by enabling the exchange of member-specific information through electronic messages delivered directly into EHRs. Health plans use Pareto Engage today to improve risk and quality outcomes by delivering timely patient-level clinical and quality information with providers in their current workflow. To support these initiatives, we also deliver industry-leading risk adjustment solutions that go beyond standard suspecting and help health plans improve risk documentation completeness in the most efficient, cost effective method possible.
With over 12 million lives flowing through the Pareto platform, health plans nationwide use Pareto’s robust solutions to improve outcomes. Contact Kunal Yajnik at email@example.com or (614) 580-3365 to schedule a demo.
PharmMD is a data-driven healthcare technology leader in medication adherence insights and health outcomes. Our solutions are tailored for Medicare Advantage, Managed Medicaid, commercial plans, as well as self-insured employers where we deliver to achieve value-based care initiatives of higher quality and lower cost of care. As always, we continue to put people first, one person at a time. 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.
R Systems is a global leader in providing technology and AI/analytics solutions. We build AI-driven products and solutions for organizations across the globe, thus delivering on the promise of digital transformation.
We serve over 1000 global clients across industries, that include the Fortune-500 and mid-sized organizations. We have continued to empower our clients with cutting-edge technologies for over 25 years, with 15 delivery centers and 25+ offices worldwide.
RCM’s Risk Adjustment Coding and Quality Improvement model utilizes Hierarchal Condition Category (HCC) navigation software to not only receive a high-volume of charts, but enables timely turnaround for coding, QA/OR, and submission of RAPS and EDS reporting files. Our highly trained team of Risk Adjustment experts are US based and all work from secure RCM computers. RCM’s solutions are available on a per-chart or hourly bill rate basis. We stand by our guarantee for agreed upon production and accuracy metrics.
Revel is a bold healthcare technology company that is reinventing health engagement to make a profound difference. Our health engagement platform, Revel Connect helps health plans and providers improve healthcare member experiences, drive better outcomes and redefine what’s possible. From closing gaps in care to boosting Star ratings, our engagement engine helps healthcare organizations leverage data for personalized connections that drive better experiences and higher quality. Join the health engagement revolution at www.revel-health.com.
RxAnte is a leading predictive analytics and clinical services company located in Portland, Maine, and Washington, D.C., dedicated to improving medication use and health outcomes. By providing plans and providers with actionable insights, strategies, and our own portfolio of interventions, RxAnte empowers clients with the resources necessary to help make medications work better for everyone.
Created by experts in advanced analytics, medication adherence, health IT, and quality improvement, the RxAnte portfolio of solutions includes patent-pending platforms that feature predictive and decision analytics, advanced program evaluation methods, a web-based workflow solution, and an award-winning call center. Together, these tools provide clients with the insights they need and results they want to improve the way medications are prescribed, taken, and paid for.
SCIO Health Analytics, an EXL company, is a leading health analytics solution and services company serving healthcare organizations across the continuum including providers, health plans, PBMs, employers, health services and global life sciences companies. SCIO provides predictive analytics and insights as a service to transform data into actionable insights, helping healthcare organizations identify opportunities and prescribe actions to drive operational performance and address the healthcare waste epidemic while improving care quality. www.sciohealthanalytics.com
Secure Exchange Solutions
For over 26-years, Sharecare Health Data Services (formerly BACTES) has been protecting PHI by acting as the dedicated Health Information Handler for providers nationwide … a provider-base which projects to exceed 70,000 by the close of 2018.
We’d love to share how we provide best-in-class chart retrieval fulfillment coupled with minimal provider abrasion, all with the added value of additional medical record related services.
Smart Data Solutions’ strives to make the healthcare market more efficient by leveraging technology to provide effective, high-quality claims processing solutions. We’re committed to providing an unparalleled level of customization & place great value on providing personalized service. We’ve helped over 320 healthcare payers, providers & networks across the nation reduce costs, decrease turn-around-time, improve payment accuracy, & increase process capability and control. Specialties include EDI/Clearinghouse, Paper Processing, Data Capture, Claims Management, Enrollment & Workflow Automation.
Partner with a leader in Revenue Protection™ TransUnion Healthcare enables provider partners to identify and maximize reimbursement opportunities with market-leading revenue cycle technologies, extensive consumer data assets and financial behavior. Our best-in-class data and analytics can help engage patients early, ensure earned revenue gets paid and optimize collections strategies. TransUnionHealthcare.com
At Vatica Health, our mission is to improve the quality of healthcare and keep populations healthy at a lower cost. We deploy local clinical consultants armed with our proprietary technology, including computer assisted diagnostic coding, to independent practices that need the most help in value-based care. Our clinical documentation is compliant with today’s increasingly complex regulations and enhances risk-adjusted reimbursements, lowers audit risk, and improves quality of care.
Vee Technologies is a pioneer in outsourced healthcare, insurance, financial, and engineering services. The company has delivered secure HIPAA compliant, ISO-certified, quality work to its customers since 2001. One of Vee Technologies' biggest strengths is its very own Sona University which custom-trains students to directly meet the ever-changing demands of today's global marketplace. Vee Technologies commits to deliver excellent solutions, guided by innovation and security, to achieve and render extraordinary outcomes.
Veradigm is an integrated data systems and services company that combines data-driven clinical insights with actionable tools for clinical workflow, research, analytics and media. Our solutions are designed to help key healthcare stakeholders to improve the quality, efficiency, and value of healthcare delivery—from biopharma to health plans, healthcare providers, health technology partners, and most importantly, the patients they serve.
As the health care industry transforms and expands, Verisys continues to grow its data and innovate solutions to serve every practitioner and industry segment with the most data and the most experience. Our experts know health care and we strive to understand our customers workflow, processes and challenges every step of the way. Ultimately leading to a 360 approach to help those who serve patients protect patients.
Virence is a leading software provider that leverages technology and analytics to help healthcare providers across the continuum of care effectively manage their financial, clinical, and human capital workflows. Virence offers a comprehensive suite of innovative technology-enabled solutions that aim to improve quality, increase efficiency, and reduce waste in the healthcare industry.
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.
Stop by our booth to see the new RetinaVue 100 Imager in action—the world's most advanced handheld fundus camera!
Wellframe helps healthcare organizations support every aspect of health beyond the four walls of care delivery. We provide care transformation services, a patented engagement platform, clinical programs that support the clinical and social determinants of health, and rigorous measurement.
Wellframe delivers clinical programs to patients’ smartphones or tablets in the form of a customized, interactive daily health checklist. With intervention alerts and secure two-way messaging, Wellframe facilitates long-term, trusted relationships between patients and care teams.
The Clinical Effectiveness solutions from Wolters Kluwer help healthcare organizations and professionals harmonize care and reduce unwanted variability by aligning decisions. Care teams in over 180 countries make evidence-based decisions with Lexicomp®, Medi-Span®, and UpToDate® in their workflow, and empower patients to participate in their care with Emmi® programs.
Zipari is a modern consumer experience solution that serves more than 10 million members through our partnerships with health carriers. Zipari has pioneered consumer experience technology exclusively for health carriers. Our platform offers unparalleled insights of every member touchpoint, the most accessible and comprehensive member profiles, and configurable solutions that build on your current technology. The result? Personalization for members that promotes satisfaction and motivates self-service, while driving operational efficiencies. Zipari’s technology enables the type of member relationships that insurers want, and consumers seek. With native understanding of the industry and exclusivity as a sector specialist, we instinctively share our clients’ goals, aspiring to new possibilities for consumer relationships that will unlock all the potential that health insurance holds.