Health Technology
Article | July 5, 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 | September 8, 2023
Do you know you can now wear technology?
With the help of wearable technology, it's now easier to keep track of useful information in one go! This go-to technology has made people’s lives easier and smoother health-wise.
In the last five years, more people have started using wearable technology to monitor health data and live healthier lifestyles.
According to the Deloitte Global Survey, today, more than 80% of people are interested in using wearable technology. Statista also studied that the ear-worn wearable technology market will be worth more than 44.16 billion US dollars by 2023. These data show that customers are gravitating toward wearable technology due to its simplicity and convenience.
The Tech is Getting Smarter
Wearable technology has enabled the concept of self-checking, evaluation and monitoring of certain health conditions.
The Internet of Things (IoT) technology is transforming and improving the entire lifestyles of millions of people. So it's no surprise that the technology is spreading. Thanks to IoT and AI, which have pushed these technologies into individuals’ hands in the form of smartwatches, fitness bands, and other devices. In this case, app development has also been a critical success factor.
Consumers of all age groups actively use wearable technology for multiple physical benefits, such as monitoring daily activities (running, walking), water intake, heartbeat, sleep cycles, blood pressure, oxygen level, and mobility levels. In fact, the tech helps them to stay motivated by maintaining and extending their good habits.
Wearables can measure these characteristics through an effective data model that is instantly responsive. The readings can be saved, displayed, or forwarded to a doctor for medical study. This interface of wearable technology saves money and time traveling to clinics, hospitals, GPs, and other medical facilities.
The next feature that only wearable technology provides is reminders and inspiring information! Due to the addition of automatic functionalities, users have invested considerably in wearables and sparked the usage at the current time.
Furthermore, wearable technology is also seen in other medical devices such as ECG monitors, which is again a cutting-edge consumer electronic device that users can use to measure electrocardiograms at home. A Deloitte study found that due to the rising demand and supply together, nearly 200 million wearable gadgets will be marketed globally by 2023.
Transforming Healthcare Towards Intelligence
The pandemic accentuated the importance of wearable technology the most, particularly for health monitoring. As a result, the technology was available in every second home.
Wearable innovation is exceptional with the advancements in sensors, artificial intelligence, machine learning, and algorithms. Sensor data provides insights regarding an individual's activity levels, cardiac pattern discrepancies, and other aspects. For example, many companies and manufacturers employ PPG, Raman spectroscopy and infrared spectrophotometers to enable blood pressure monitoring features in smartwatches and portable medical devices.
The combination of technology with intelligence is creating a whole new world of healthcare where individuals can track, record, and improve their health issues in a lesser timeframe.
A Committed Future of Healthcare
So, will technology for health improvement thrive?
The answer is yes. Wearable technology delivers real-time health data and allows consumers to improve their health without incurring high costs. Consumers' willingness to share their data with healthcare professionals indicates a surge in future demand for wearable technology gadgets.
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Health Technology, Digital Healthcare
Article | August 16, 2023
Since ChatGPT’s launch in November 2022, artificial intelligence (AI) tools have become disruptive to nearly every industry. While there's been controversy about whether AI would benefit the healthcare industry, it has proven to be just as capable in healthcare as in other sectors.
In the medical field, there is reason to believe AI tools may be an even more reliable and useful resource than other sectors. Medical students have been panicking over AI's threat to their career prospects. But as these systems mature, the experts increasingly believe that AI may serve as a counterpart to human medical expertise rather than a threat.
How AI Tools Are Expected to Aid Medical Professionals?
Again and again, as the debate over modern AI tools rages on, we encounter the analogy of the calculator. No one feels threatened by calculators, not even professional mathematicians. Instead of throwing up their hands, math experts embrace the power of these now archaic computerized devices. If the experts are correct, this may be similar to the future of the alliance between AI and humans.
According to the designers and programmers who understand how these systems work as well as how information technology tends to progress, AI can be expected to help the medical profession in the following ways:
Cosmetic Surgery Consultations
One of the farthest-reaching applications we see develop is in consultations for plastic surgery and similar applications. Perhaps one of the easiest aspects to understand is hair-loss consultations. In our practice, we use a device known as HairMetrix, which uses an AI-driven analytical system to help determine what is causing a patient to lose their hair and which treatment options would be the most effective.
Because it is AI-driven, it is fully based on visual scans and is completely non-invasive. Just like this, AI can be used in an abundance of other ways to minimize the use of exploratory surgery and improve healthcare outcomes.
Improved Diagnostics
Artificial intelligence is already helping medical providers deliver diagnoses more quickly. These tools can identify anomalies that might otherwise take human hours or even weeks to identify. This has improved the rate of cancer detection, among other things, which will predictably improve survival rates.
Developing New Pharmaceuticals
The development of new medicines is notoriously slow. Not only is testing a painstaking process, but even seeking FDA approval can take years. AI is expected to help the development of pharmaceuticals through simulation on the molecular level, allowing researchers to see how the active mechanisms in a drug will work in the body.
Improved Administrative Efficiency
In the medical field, administrative tasks are notoriously slow. It is believed that generative AI will be able to automate many administrative functions and innumerable office chores. It could streamline sorting patient files, accelerate the interpretation of data, and much more.
Patient Access
In an area where information technology is already improving patients' lives, access to medical advice is still a bottleneck in the system. AI tools have the potential to slowly bridge the gap in health disparities. Combined with the power to diagnose, this could dramatically increase the capability of online patient portals.
Of course, this list of anticipated AI capabilities is far from exhaustive. Researchers and medical professionals have high hopes for these tools, and some are already proving to be more than mere speculation.
In a world where AI is reshaping industries at an unprecedented pace, the healthcare sector stands poised to benefit significantly from this technological revolution. From streamlining administrative tasks to revolutionizing diagnostics, the potential of AI in medicine is vast and diverse. As we witness AI-enabled tools like HairMetrix, enhancing the cosmetic surgery consultations and AI algorithms expediting diagnostic accuracy, it's clear that we are only at the beginning of a healthcare transformation that is set to improve patient care, increase survival rates, and revolutionize medical practices.
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Health Technology, Medical Devices
Article | April 17, 2023
Contents
1. Getting Started with LIMS Software
2. Benefits of Incorporating LIMS Software into Lab Management
3. LIMS Software Classification
4. Selecting the Right LIMS Software: A Comparison of Variants
5. How LIMS Software Revolutionized Laboratory Management
6. Future Scope
1. Getting Started with LIMS Software
Laboratory Information Management System (LIMS) software automates laboratory operations, improves productivity, and ensures the accuracy as well as reliability of laboratory data. It can be implemented in clinical laboratories, research & development labs, and environmental testing labs and tailored to meet specific needs. LIMS software seamlessly integrates with other laboratory systems, such as electronic lab notebooks and scientific data management systems.
LIMS class software enables storing and managing all information in one place, improving day-to-day work. Yet, research reveals that still 40% of industry leaders 'had not embarked on applying digital to research and development or quality control labs'.
(Source: Accenture)
2. Benefits of Incorporating LIMS Software into Lab Management
By implementing LIMS software, laboratories can significantly reduce time spent locating samples and records, entering data, and generating reports.
LIMS software also offers additional advantages when integrated into laboratory management, such as
1. Optimizing: LIMS automates laboratory processes, allowing for a paperless environment and increased productivity. It also ensures accurate test results by preventing the use of outdated instruments.
2. Automating: LIMS facilitates the input of essential sample information, including its source, date, time, and location of the collection as well as processing data.
3. Compliant: LIMS helps labs follow FDA regulations by creating an audit trail that tracks all activities, including record creation, modification, and deletion. It also enables electronic signatures to authenticate key activities and keep data secure and traceable.
4. Collaborative: LIMS streamlines inter-laboratory collaboration through the option to share data access. This allows lab technicians from disparate laboratories to be seamlessly assigned to different projects and obtain the required information without disruption.
5. Security: LIMS systems offer various mechanisms for managing user access, such as an in-built user management system with a unique username and password, integration with LDAP or Active Directory for user authentication, and access through an Identity Server.
3. LIMS Software Classification
Laboratory Information Management System software can be classified based on several criteria, including functionality, deployment model, industry focus, and the laboratory's needs.
Here is a list of critical features that can be considered while classifying LIMS software:
1. Functionality: Different LIMS software may have varying functionality, including sample tracking, data management, instrument integration, quality control, workflow management, and reporting.
2. Deployment Model: LIMS software can be deployed on-premises or in the cloud. On-premises deployment means that the software is installed and run on the laboratory's own servers, while cloud-based deployment means that the software is hosted and maintained by a third-party provider.
3. Industry Focus: LIMS software can be designed for specific industries or applications, such as pharmaceutical research, clinical laboratories, food and beverage testing, environmental testing, and more.
4. Open-Source vs. Proprietary: LIMS software can also be classified as either open-source or proprietary. Open-source software is freely available and can be modified by users, while a company owns proprietary software and requires a license to use it.
5. Scalability: The size of the laboratory and the number of users accessing the LIMS software can also be a factor in classification. Some LIMS software may be more scalable, allowing for easy expansion as the laboratory grows.
6. Integration Capabilities: LIMS software can also be classified based on its ability to integrate with other software or instruments. Some LIMS software may be more flexible and have better integration capabilities than others, allowing for seamless data exchange between different systems.
4. Selecting the Right LIMS Software: A Comparison of Variants
While selecting the most appropriate LIMS variant, the wide range of available options can pose a challenge for laboratory decision-makers. To aid in this selection process, a comprehensive comparative analysis of LIMS variants is presented below:
1. Lab managers can adopt an objective approach for evaluating and comparing different LIMS solutions by creating a grading rubric. This involves designing a table with separate columns for each LIMS vendor and rows listing the desired features as well as functionalities. To provide a more comprehensive evaluation, advanced rubrics may include rating each functionality on a particular LIMS using a scale of 1 to 5.
2. Next, it is crucial to review how LIMS solutions are structured and stored. This includes determining whether the solution is on-premise or cloud-based, either as a platform-as-a-service (PaaS) or software-as-a-service (SaaS). For optimal flexibility in the laboratory's computing structure, choosing a vendor that offers LIMS as a comprehensive solution is advantageous.
3. Data access must be controlled by using unique user IDs and passwords. Furthermore, data security standards such as HIPAA compliance and SSL encryption will likely be mandatory across many laboratory industries. It is thus imperative to carefully consider and ensure the security features of any potential LIMS solution.
4. To assess the level of support that can be expected with a particular LIMS, one effective method is to directly inquire with the software vendor about outages, response time, and plans of action to address any glitches preemptively. Managing expectations around the LIMS requires asking about the frequency of LIMS updates, including how often the platform is updated, how updates are announced and deployed, and the expected duration of any update-related outages.
5. While selecting a LIMS solution, laboratories must establish a target go-live date, especially when implementing the system in response to, or preparation for, an audit. Software vendors should provide a deployment and implementation timeline, which can be used to compare with the laboratory's objectives and goals. This helps to ensure that the LIMS solution is implemented in a timely and efficient manner.
5. How LIMS Software Revolutionized Laboratory Management
LIMS software has fundamentally revolutionized the laboratory management system in several ways. Before the advent of LIMS, laboratory operations were often paper-based and highly manual, leading to inefficiencies, errors, and inconsistencies. However, with the implementation of LIMS, laboratories have become more efficient, accurate, and compliant.
LIMS has also improved laboratory productivity, allowing scientists to focus on higher-value tasks like data analysis and interpretation. It has enabled collaboration between different laboratories, facilitating communication and knowledge sharing between scientists, researchers, and analysts, and is also leading to more significant innovation and progress in the field of science and research.
6. Future Scope
The future scope of Laboratory Information Management System software is promising as it continues to evolve and adapt to the changing needs of laboratory management. Potential developments include integrating emerging technologies such as artificial intelligence, machine learning, and robotics, cloud-based solutions for scalability and accessibility, IoT integration for automation and safety, enhanced data analytics for improved decision-making, and mobile applications for on-the-go access. Moreover, with SaaS LIMS, there are no license costs, minimal installation fees, and no need for in-house servers or databanks, resulting in reduced IT maintenance costs for hardware and software.
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