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Services
The Value-Based Payment Programs are designed to improve quality and
efficiency in the delivery of healthcare and endeavors, as well as improve the
quality and efficiency of services provided to enrollees of Payor.
Payor Contract Management
- Negotiate VBCs with managed care organizations
- Contract evaluation for financial incentive potential
- Utilize payor portals to track HEDIS performance
- Track & Reconcile payments related to each VBC contracts
- Provide continuous support to review & validate provider roster for VBC contracts
- Track & Trend Quality and cost performance
- Disseminate contract performance to providers
- Manage all payor meetings holding payors accountable
In Practice Assistance
- Strategize with practice members to improve/prioritize patient outreach initiatives
- Schedule patient appointments directly in the provider’s EHR/PM system
- Coordinate patient care for testing, appointments & other services
- Assist with coordination of ER/Hospital transitions of care
- Support clinical staff with prioritizing VBC contracts as it relates to HEDIS outreach
Technology
- Integrated technology to automate Quality Data Reporting
- Embedded EHR functions surrounding patient engagement
- Automated Patient call systems
- Systems interoperability with Payors & other industry partners
