ACO Workflow Solutions

Stratify high-risk population using an extensive ACO system that enables providers to deliver coordinated care for chronically ill patients. Getting the right value-based healthcare solutions simplifies ACO’s workflow and anticipate any possible drawbacks. Ensure to optimize the reliable platform in order to prevent unnecessary duplication of services and medical errors. It is the best way to better manage data, enhance patient care, meet health goals, maximize performance, and render the service in a timely manner.

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Value Added:
Business Process as a Service (BPaaS) - Effective Resource Alignment

BPaaS, or Business Process as a Service, is a solution offered by MedVision that enables organizations to make better use of their resources, whether they are just beginning or expanding. BPaaS alleviates the burdensome duties organizations have internally as they innovate, restructure, or seek to better manage continuing operational expenses.

value added performance - Bpaas

BPaaS

Task Management Services

Membership

Encounter processing and reporting to health insurance – ensuring network performance timeliness standards are fulfilled

Encounters

Encounter processing and insurance submission — ensuring network performance timeliness requirements are met

Providers

Loading and updating provider information, together with contract alignments, to guarantee accurate provider reimbursement.

Health Plans

Configuration of existing or new health plan agreements, payment and carve-out structures or processes with network and out-of-network provider organizations, resulting in an unified upstream and downstream structure.

Reporting

Generating timely utilization, authorization, and claims report formats required by health plan partners – assuring compliance with important delegated processes

Workflow

Developing and maintaining each rule that influences the routing or approval, denial, and pending procedures of referrals, authorizations, and claims inside the delegated value-based organization.

BPaaS

ACO Workflow Operations Solutions

Credentialing

Full provider profiles and triggers to keep data updated – compliance with all delegated authorities, updating through primary or secondary source verifications

Referrals Processing

Manage the whole use cycle based on accepted medical criteria, making the authorization process easier as per organization guidelines.

Claims Administration

Claims from providers and facilities are processed and decided on, and payment and distribution are made.

Capitation

Manage capitation payments and provider reports that go out. Trends in how health plans are used can help find network leaks.

Contract Negotiation

Executive teams with experience analyzing contracts and frameworks for all network stakeholders, including plans, providers, specialists, facilities, and additional services. They work for you to help you make more money.

Call Center Operations

Full-cycle Customer Service department with the ability to log all incoming questions, send them to the right people, and integrate with appropriate department structures, like claims and referrals, for faster call solutions and resolutions.

MedVision's full partner alignment is the best way for any payor-based organization to handle the complex operational needs of today. Get in touch with us right away at 847-222-1006 or info@quickcap.net to talk about our services and business strategy for your company for free and with no obligation. MedVision's full partner alignment is the best way for any payor-based organization to handle the complex operational needs of today. Get in touch with us right away at 847-222-1006 or info@quickcap.net to talk about our services and business strategy for your company for free and with no obligation.

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