Health Technology, AI
Article | July 18, 2023
Dialysis providers face many of the same financial and operational pressures that affect other provider organizations, including flat or reduced reimbursements, chronic staffing shortages, and increasingly complex insurance requirements. Dialysis centers, nephrologists, and renal pharmacies also grapple with the impact of a growing shift in dialysis care to the home setting.
End-to-End Automation Can Reduce Denials, Improve Cash Flow
The good news is that despite these challenges, dialysis providers can sustain strong cash flow, reduce costs, and mitigate denials by applying advanced technology to the revenue cycle.
Here are six ways technology can help strengthen the dialysis center revenue cycle in the today’s difficult operating environment:
Identify undisclosed insurance coverage
Because patients often present as self-pay even though coverage exists, determining their true insurance status can be challenging. Yet failure to identify existing insurance can result in significant write-offs.
That’s why renal providers need technology solutions that can uncover patient coverage information before care is provided. Change Healthcare’s Coverage InsightTMsolution provides an expansive network and search-and-matching capabilities necessary to identify and confirm patient coverages at the outset of care.
The solution uses machine learning algorithms—coupled with access to vast stores of available third-party-data—to develop robust patient profiles, which can then be linked to potential funding sources. Notably, it identifies a variety of indicators, including high probability of disability, income levels and financial status, insurance sources, and other actionable information to help you verify coverage and recover revenue.
We can help identify undisclosed coverage for end-stage renal disease (ESRD) patients through Medicare/Medicaid, Disability/SSI, third-party liability, commercial insurance, state and county programs, social programs, and charity.
Expedite seamless prior authorizations
Streamlining the prior authorization process is essential to help ensure optimal reimbursement for renal care rendered, particularly with commercial insurance and Medicare. But traditional prior authorization processes are frequently time-consuming and labor-intensive and can delay necessary care.
Our Clearance Authorization software addresses the chronic problem of prior authorizations with automated functionality that can determine if prior authorization is required and on file with the payer. The solution also will automatically check medical necessity requirements at the time of registration and electronically submit requests to integrated payers.
Change Healthcare’s Connected Authorization Services go a step further by deploying pre-authorization experts to handle routine authorizations quickly using intelligent technology while working complex cases by exception to improve authorization efficiency and accuracy.
Speed adjudication with electronic attachments
As claims management processes have grown more numerous and complex, providers have struggled to ensure that the correct information is provided to the payer at the appropriate time. The result can be delayed, denied, or rejected claims.
Assurance Attach AssistTMcontributes to faster reimbursement and reductions in denials, organizational expense, and administrative burden by automating the attachments process to meet payers’ increased demands for additional documentation. Attachments are automatically delivered and matched to the appropriate claim, and once the claim is released, claim and attachment status can be easily tracked.
Expedite claims workflow for recurring services
Creating claims for ongoing ESRD care requires repeatedly documenting the same details on each claim. Revenue Performance Advisor, an end-to-end medical billing platform, provides automation that allows dialysis staff to save time by quickly replicating unchanged data from prior visits while updating date-of-service and other information to expedite claims processing.
Revenue Performance Advisor also includes eligibility and benefits verification and automated claims scrubbing that flags incomplete or incorrect claims prior to submission, resulting in a first-pass clean claim rate of 98%.
Accelerate your Medicare claim cash flow
Medicare is one of the largest payers of dialysis services, so ensuring a problem-free and expedited Medicare claims submission process is essential to strong cash flow.
Our Assurance Medicare Direct EntryTMsolution provides a single system for the real-time submission and processing of Medicare claims. It can help expedite reimbursement, reduce AR days, and speed your Medicare primary claim cash flow by at least one full business day.
Assurance Medicare Direct Entry also checks your Medicare claims for eligibility errors using the CMS eligibility transaction system (HETS). Claims needing attention are flagged and posted in Assurance Reimbursement Management for editing. You can quickly correct errors within the system before transmitting the claim directly to Medicare for validation and payment processing.
Optimize patient liability
Making it easy for patients to receive, understand, and pay their portion of the medical bill is key to ensuring a healthy revenue cycle, mitigating the need for collection services, and improving patient goodwill.
With our Patient Billing and Statements solution, Change Healthcare serves as your strategic communications partner, delivering multi-channel, personalized print and digital statements to help expedite patient payment collection.
The solution is designed to provide fast, effective statement and invoice processing, printing, and mailing—cutting your costs and getting you paid sooner. Our advanced statement printing allows you to bypass conventional and time-consuming folding, stuffing, and stamping.
SmartPayTMconsolidates each step of the billing and payment process into one place, enabling you to collect more patient payments, get paid faster, reduce your collection costs, and lower patient write-offs. With multiple payment channels, including online, mobile, telephone and via mail, SmartPay helps expedite patient payments before, during, and after the encounter.
A single, trusted partner
Change Healthcare’s deep knowledge of the renal care landscape and our development of disruptive technologies to overcome traditional revenue cycle barriers can help dialysis centers achieve unprecedented revenue cycle excellence.
And unlike many point solutions that only address a specific revenue cycle issue, Change Healthcare’s technologies are part of a comprehensive approach delivered through a single, trusted vendor. That translates into improved process integration and continuity, as well as simpler overall accountability.
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Health Technology, Digital Healthcare
Article | August 21, 2023
A wealth of evidence supports the health benefits of keeping pets: increased life span, exercise, improved mental health, and a sense of purpose. But for older adults and those with disabilities, the responsibilities and expense of owning an animal can be overwhelming, and caregivers are often forced to take on those burdens themselves. To make matters worse, dementia patients can pose a physical threat to live animals.
What alternate solutions exist for those who cannot safely or practically keep a live pet? Fortunately, information technology and robotics have advanced to the point that realistic, robotic emotional support pets are becoming a legitimate option. As research in this area advances, experts have found that robotic emotional support animals can offer a myriad of benefits similar to those associated with live pets. Robotic companions can also help caregivers.
Robotic Emotional Support Animals in Practice
Imagine the following scenario: An elderly woman with dementia suffering from Sundowner’s Syndrome relies on a strict daily regimen established by her caregiver. This routine is a delicate dance, balancing the patient’s meals, medication, and personal care, all designed to keep her as relaxed as possible.
One afternoon, as the caregiver prepares dinner, the caregiver realizes that the patient’s beloved dog is nowhere to be found. She runs outside to look for the dog, leaving the patient to fend for herself. The patient is agitated over her missing dog and suddenly alone in a kitchen with pots and pans boiling.
Fortunately, the caregiver finds the dog outside, but the patient is now too overwhelmed to eat or take her medication. Despite the caregiver’s best efforts at redirection, it’s a rough evening for everyone.
How a Robotic Emotional Support Animal Can Ease the Role as Caregiver
As any experienced caregiver knows, consistent emotional support for patients is critical. A robotic emotional support animal can significantly ease a caregiver’s role in this respect. Robotic companions replicate many benefits traditional pets provide – affection, responsiveness, and companionship – without the associated caregiving demands, such as feeding walking, or veterinarian visits.
The Benefits of Robotic Emotional Support Animals
The owners of pets are known to enjoy
Reduced impact of depression
Lower blood pressure
Reduced triglycerides and cholesterol
Longer survival rates after a heart attack
30% fewer doctor visits after age 65
Longer life spans
Robotic companion animals provide genuine comfort, mirroring the emotional connection that living pets provide while lightening the caregiver load. Uplifting conversations about the robot companion elevate the moods of both patient and caregiver, potentially reducing feelings of burnout. In embracing such technology, senior care and assisted living facilities can foster an environment that makes staff and residents all smile a little more.
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Healthtech Security
Article | August 31, 2023
Combating stress and anxiety can be a major challenge these days, but there are certain behaviors that contribute to those feelings, and you can take action right now to stop them and focus on your wellbeing. By taking a look at the way you react to others, how you practice self-care, and what kind of attitude you approach new tasks with, you can make some positive changes to your lifestyle that affect both your personal and professional lives.
Stop stressing over your current job
Almost everyone experiences job-related stress at some point in their lives, but when those feelings become overwhelming, it may be time to consider your options, according to Zenbusiness.com. Those in corporate positions and high-level management often cope with the most stress or anxiety due to the number of people they have working under them. If you find yourself bringing home feelings of irritability, or if you suffer from insomnia or a lack of focus during the day, take a look at open positions elsewhere and think about how much moving on could help you maintain a higher level of mental health. It can be scary to think about making such a major life change, but you’ll never know what possibilities lie out there if you don’t take a leap.
Stop competing with others
While some competition in the business world is a healthy motivator, other types can leave you feeling terrible about yourself. Rather than comparing your lifestyle or achievements to someone else’s, try to practice gratitude each day by using mindfulness techniques that allow you to focus on your own actions. Focus on your strengths and remind yourself that you’re doing the absolute best you can each day. Make it a point to congratulate others on their achievements, especially your coworkers, and do what you can to build others up. When it comes to social media, remember that the things we share only give a glimpse into the whole story, and that comparing your life to another’s can be detrimental to your mental wellbeing.
Stop ignoring your physical needs
While your mental wellbeing is obviously an important focus, it’s also crucial to think about how you can make sure your body is getting everything it needs. Working a corporate job often means sitting stationary at a desk for long hours, working through lunch hours, or working at home even after you’ve clocked out for the day. Allow yourself to rest by setting boundaries once you’re home, and give yourself the tools to get better sleep by creating an end-of-day routine that will help you relax and prepare to let the workday go. Eat plenty of lean protein and leafy greens to keep your energy up, and make it a point to get up and move around at work. You might also invest in a standing desk, as those come with multiple health advantages for individuals who spend much of the day sitting.
Stop dreading the new week
It can be helpful to set some boundaries where work is concerned, but it’s also important to get organized in order to banish that dread you feel on Monday morning. Facing a busy week can bring on stress and anxiety that leaves you feeling unprepared, but if you take the time to write out a to-do list on Friday, you can jump right in at the beginning of the week without feeling frazzled. It can also help to have something to look forward to, such as promising yourself a little treat once you get a certain amount of work done. Staying productive can be a big help, so if you have time left toward the end of the day and there’s a small task still to be done, don’t let your desire to leave early on a Friday afternoon take over. Finishing up can give you a sense of satisfaction and will keep you from feeling overwhelmed once the new week starts.
Stop saying yes to everything
Another behavior that leads to feeling overwhelmed is saying “yes” to anyone who asks for your time or energy. You may feel that doing so contributes to a helpful, team-oriented atmosphere at work, but it becomes a problem when you take on too much without focusing on your own needs at least part of the time. Learning how to diplomatically say no when you can’t take on any more responsibilities is a form of self-care that can banish stress and allow you to focus on your own needs without feeling guilty.
Letting go of stress, anxiety, and poor health habits can take some time, but by creating some new routines you can learn new habits that help you tackle anything life throws your way. Write down a strategy that encompasses your daily schedule, and get organized both at work and at home for maximum mental health benefits.
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AI
Article | December 21, 2021
Global efforts to tackle gender inequality have grown in recent years. But there is still so much to be done. Figures from the United Nations show that outcomes for women and girls continue to lag across a range of issues, including poverty, education, work and health. And according to the World Economic Forum, at the current rate, it will take 108 years to close the gender gap.
Although healthcare is founded in objectivity and science, gender bias is still remarkably common. We wanted to understand more about female perceptions of healthcare, so we undertook consumer research that delved into the experiences of women compared to men. The results pointed to a clear disparity, finding that women are less likely to visit the doctor when they have symptoms of ill health and, in some cases, are taken less seriously when they do seek medical advice.
Women being left behind
According to our research, a significant proportion of British women feel disappointed in the healthcare they receive, with one in five reporting they weren’t taken seriously when presenting symptoms to a healthcare provider. What’s more, a staggering one in four said they are reluctant to seek medical advice at all for fear of wasting a GP’s time. These statistics suggest that, not only are female experiences of healthcare damaging their relationship with clinicians, but they could be eroding confidence in recognising and acting on warning signs and symptoms too.
This sentiment is particularly evident when focusing on cardiac care. One in eight women (13%) feel ignored when presenting symptoms of heart disease to healthcare professionals, compared to just 4% of men. And of UK adults who have received a coronary heart disease (CHD) diagnosis, women experiencing symptoms were 55% more likely than men to visit the doctor multiple times before receiving a referral for further investigation. On top of this, women are five times more likely to receive a false finding from the cardiac stress tests that are traditionally used to assess heart health.
“There does appear to be a gender bias in onward referral to secondary care and for diagnostics in the local area, which is influenced by the attending healthcare professionals’ risk assessment. Traditional teaching has led to gender bias, as we are programmed to attribute a lower level of pre-test probability and risk to females. This may have contributed to a general lack of awareness around cardiovascular health in women. For example, in a survey I carried out among more than 600 female employees working within North West Anglia NHS Foundation Trust, 82% said they didn’t feel informed about their cardiovascular health. Considering participants included some of the most medically informed women in the UK, the results speak volumes about how we view cardiac health among women.”
- Dr Rebecca Schofield, consultant cardiologist at North West Anglia NHS Foundation Trust
These widespread misconceptions around heart disease and heart attacks are often exacerbated by what we see in the media – think of the countless TV stereotypes of male characters clutching their chests and falling to the floor.
But given that CHD is responsible for one in 13 female deaths, it appears that public health efforts have failed to make people aware of the risks for women. It is, perhaps, not surprising then that 42% of women with CHD did not immediately recognise their symptoms as signs of heart disease. In short, women are missing out on time-critical diagnoses and treatment due to a lack of awareness and education among both healthcare providers and the public.
Technologies making a difference
Thankfully, progress is being made to improve healthcare outcomes for women. Innovative technologies are increasingly providing diagnostic solutions that can reduce incidences of human bias and give clinicians greater clarity on the presence or severity of different conditions in their female patients.
For example, AI is already being used to detect diseases such as cancer more accurately. Its adoption is facilitating reviews and translations of mammograms 30 times faster, with 99% accuracy, reducing the need for unnecessary biopsies.
There’s extraordinary potential for AI and healthcare, and it’s something the NHS continues to recognise, most recently with the launch of its Artificial Intelligence Laboratory (AI Lab) and NHS England’s (NHSE) MedTech Funding Mandate. The latter aims to accelerate the uptake of selected innovative medical devices, diagnostics, and digital products to patients.
As part of the NHS efforts, NHSE has mandated the HeartFlow Analysis for use in hospitals across England for patients, male or female, who might otherwise be sent for a cardiac stress test. The HeartFlow Analysis is a gender-neutral technology that takes data from a coronary CT scan of the heart and leverages deep learning (a form of AI) and highly trained analysts to create a personalised, digital 3D model of each patient’s coronary arteries. This then helps clinicians to quickly diagnose CHD and decide the appropriate treatment for patients of any gender. Time spent in hospital is minimised for patients and often layered testing and unnecessary invasive diagnostic procedures can be avoided.
Final thoughts
While AI is helping us tackle gender bias in certain areas such as oncologic and cardiac testing, healthcare professionals are not absolved of responsibility when it comes to confronting this problem. It remains incumbent upon clinicians to recognise unconscious bias that would deter them from referring women or minority patients for much-needed testing.
Outside of the hospital, public health education efforts must expand so that far more of us can recognise shortness of breath, nausea, vomiting, back or jaw pain, and other symptoms beyond chest pain to be indicators of a heart attack in a woman. Knowing what to look for and overcoming personal bias that might lead to these signs being disregarded, may allow us to help one of the more than 100 women who will experience a heart attack in the UK today.
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