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The Availity ® Health Information Network: Capabilities and Connectivity Supporting the Next Generation Revenue Cycle Good for Health Plans, good for Delivery.

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Presentation on theme: "The Availity ® Health Information Network: Capabilities and Connectivity Supporting the Next Generation Revenue Cycle Good for Health Plans, good for Delivery."— Presentation transcript:

1 The Availity ® Health Information Network: Capabilities and Connectivity Supporting the Next Generation Revenue Cycle Good for Health Plans, good for Delivery Systems, and good for Patients

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3 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 Tomorrow’s Information Needs 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

4 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

5 Clinical Documentation

6 Overview Providers Hospitals Medical Attachments Clinical Summaries EMR Integration with Availity ® CareProfile ® The Availity Network Health Plan Admission Concurrent Review Lab Results Discharge Information Medical Attachments Clinical Data

7 Integrated Clinical Documentation Value Propositions Cost / Quality / Compliance Care Coordination Revenue Cycle Care Management PCMH / ACO Risk Management HEDIS / Stars Administrative Savings

8 Inpatient Information Exchange

9 Integrated Authorizations Displays status of authorization Displays Patient Acct #, Patient Name, Medical Record # Displays facility name, health plan info Quick search Displays Patient Class, admit date, discharge date, diagnosis Displays auth responses, ADT message data, user comments by patient Refresh screen Exports to.csv file Allows user to set filters by facility, date, auth status or health plan

10 Integrated Discharges

11 Medical Attachments

12 Clinical Summaries for Care Managers Provider NPI, Name, Group Name Patient Name, DOB, Member ID Allergies Date of Service Chief Complaint Problem List HPI Review of Systems Assessment and Plan Medications Progress Note Diagnoses Consult Procedure Codes (CPT, HCPCS) EMRs Allscripts Athenahealth eClinicalworks Epic GE Healthcare Greenway MedPlus NextGen Vitera Structured data CCDc32

13 Availity ® CareProfile ® with EMR Integration

14 Integrated Clinical Documentation Value Propositions Cost / Quality / Compliance Care Coordination Revenue Cycle Care Management PCMH / ACO Risk Management HEDIS / Stars Administrative Savings

15 Good for Health Plans, good for Delivery Systems, and good for Patients

16 The Availity ® Health Information Network: Capabilities and Connectivity Supporting the Next Generation Revenue Cycle

17 Thank you


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