供应商

英雄
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Delivering patient-centric care is a prevailing focus for providers, 但是管理任务, 技术和流程效率低下, and a lack of clear and comprehensive patient data can often get in the way. Our team has decades of experience working alongside providers — modernizing systems to alleviate burdensome processes and making improved patient outcomes possible. We provide powerful services and solutions supported by unmatched expertise to ensure opportunities for efficiency and eliminate barriers to high performance.

We are passionate about delivering what matters most to those who can make the most impact.

减少复杂性,改善生活

提高的结果

减少摩擦

优化成本效率

足球外围平台如何提供帮助

足球外围平台的模块化 solutions are purpose-built for providers — optimizing processes, 提高成本效率,提高护理质量.

Gainwell团队知识渊博, and our systems set the standard for provider optimization. 足球外围平台可以帮助加快索赔处理, support value-based care and control escalating costs while orchestrating workflow and task management.

护理管理

Improve quality and reduce the total cost of care with our interoperable 护理管理 platform — built on a foundation of automation, 标准化和成熟的流程和 使用著名的, industry-standard COTS products like the Johns Hopkins ACG® System as well as administrative and clinical information.

临床索赔审查

Identify coding, location, level of service and reimbursement errors pre- or post-pay. Our 临床索赔审查 solution uses artificial intelligence to select the claims most likely to have errors and clinical expertise to compare them against medical records.

EDI清算所

Simplify provider billing with comprehensive validation rules for managed care and fee-for-service transactions and ensure your encounter data is compliant through a single point of submission.

资格认证

Verify member eligibility while providing clarity on the decision to staff — ensuring they can explain, 与敏感性, 为什么有人不符合资格.

FraudCapture®

Gain end-to-end support in the identification of fraud, waste and abuse. 足球外围平台的模块化, cloud-hosted platform exposes issues through clear visualization and easy-to-navigate exploration tools.

付款方式分析

Pinpoint claims that have been improperly billed or paid while minimizing abrasion in the process. Our 付款方式分析 solution uses proprietary data analysis tools to compare claims history across many criteria that client systems or claim processors often miss.

复苏后付费

Capture and recover dollars lost as a result of improperly paid claims. Our Post-Payment solutions leverage AI and machine learning to ensure accuracy in the claims review process and efficient, digital processes to pursue recoveries and maximize savings.

预付款的全球十大外围足球平台

最大限度地避免你的计划或项目的成本. Our tenured market expertise pairs with our end-to-end COB solutions to amplify speed to delivery and provide truly actionable insights.

事前授权规则引擎

Automate and expedite authorizations for your state with configurable rules and workflows designed to improve member and provider satisfaction.

提供全球十大外围足球平台

Create new efficiencies within provider management processes, from initial enrollment through final determination letters to support participation in fee-for-service and managed care programs.

利用管理

Validate the appropriateness and necessity of services and procedures to contain costs in your plan or program. 利用管理 addresses your most pressing needs by combining cost management with accurate pre- and post-payment claim reviews and prior authorization from our Clinical Care Reviews.

足球外围平台可以帮忙. 但下一步是你的了!

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额外的见解

投资于免疫——为了它的全球十大外围足球平台
Whole Person Care, Social Determinants of Health and Whole Person Service - Part 2
构建更加公平的公共卫生体系