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A White Label Turnkey Portal
For Workers' Compensation, Group Health, and Direct Primary Care Models to allow doctors to get authorizations for patient treatments in real-time rather than waiting several days for decisions to come via fax.
-Directing services from Medical Home
-Getting care approved faster for injured workers
Introducing inCONNECT ™
Workers Comp, Group Health, Direct Primary Care Markets
New software that allows doctors to get authorizations for patient treatments in real-time rather than waiting several days for decisions to come via fax.
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A treating physician would get a prior authorization response right on the spot--either a green light to treat or message to escalate for further utilization review.
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Prior authorizations identify whether a treatment falls within evidence-based medical standards of care, whether it's something covered under the insurer's policies, and the costs of the service versus the anticipated benefit to the patient.
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It redirects staff and resources to more value-added activities both for the insurer and for the provider and the patient.
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To manage by exception eliminates waste, changes focus to productive outcomes
Watch for Movement in the Following Areas
Gold star providers-merit based & monitored
Direct access to trained Behavioral Health Providers
Policy development and systemic change
Medical Treatment Guidelines, clarity and ease of use
Stronger evidence-based medicine documentation
Documentation rationale
Pertinent reporting infrastructure
Structured provider-patient communication
Quality performance outcomes payments
Psychological screenings/assessments
UR impact on Rx
Take action on polypharmacy and prescription cascades
Sea of Change
Provider -Patient Engagement Techniques
Protocol definition with literature
Guidelines clarity and training
Web-based tools in line with workflows
Frequent touchpoints, trust relationships
Feedback loops, collaboration
Evidence-based results with clinical utility
Documentation rationale and coaching
Management support
Patient satisfaction, health outcomes
Behavioral change support
Articulated vision
Ways to Engage
Market Insights
"By leveraging health information technologies, organizations can create a clinical focus around communication and commit to active measures to support accountability" -The Joint Commission, Division of Healthcare Improvement
"The goal in Workers' Comp is for providers to spend more time focused on best care and less on pure administration, for example UR form completion" -California Workers' Compensation Institute
"If the system is more efficient and patient care is rendered faster, then employees get back to work sooner, and that will really reduce indemnity cost" -CMO State Compensation Insurance Fund
"Communication errors are a contributing factor in medical malpractice claims and one of the leading causes of medical errors and harm; it's attributed to ineffective closed-loop communication and failure to establish clear lines of responsibility. -The Doctors Company
"Poor communication between primary and secondary care is one of the top 3 root problems leading to mistakes" -Lean Six Sigma Blackbelt Analysis in Patient Safety Risk Management, Physician Empowerment Suite
"Implementing a standardized communication tool, as a guide for communicating changes in status, is directly associated with better outcomes." -Agency for Healthcare Research and Quality
"Effective patient-provider communication is linked empirically to outcomes including health status, patient satisfaction, recall of information, adherence" -National Institutes for Health
"Consumer pressure is driving a disruptive technology-enabled shift in healthcare today. Digital health technologies are beginning to deliver on their promises to help providers understand individual preferences and provide personalized care that effectively coordinates care throughout the broader health ecosystem."
-President & CEO HIMSS
inCONNECT PORTAL ™
The new paradigm for in-network access to providers and services