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Since the mid-‘80s, specialty networks have gained momentum in capturing segments of the patient populations that are aligned with health maintenance organizations and other insurers. Their goal is to provide a more focused and cost-effective approach to care while serving a more engaging patient experience. In the ongoing evolution of the healthcare market and continued medical cost pressures, specialty networks embrace new opportunities in their approach to care and cost management.
Behavioral health organizations
Eye care focused providers
Surgery-based specialty networks
Orthopedic network solutions
Dermatology centric organizations
Manage and customize provider panels to manage patient volume
Establish comprehensive benefits configuration and control
Design customized care management plans
Streamline utilization management of auto referral process
Create intelligent auto claim adjudication and workflow routing schemes
Build fee-for-service and capitation-based reimbursement structures
Manage stop loss configuration and reporting
Integrated evidence-based care guidelines
Generate audit and reporting management
Connect via HIPAA-based EDI functionality with health plans and providers
Manage via executive and department level dashboards and actionable oversight
Configure shared and full-risk Division of Financial Responsibilities
Identify providers with specified characteristics and within a radius of a given member
Today, QC7 provides an advanced infrastructure that specialty networks require for care and process management, whether from a traditional fee-for-service perspective or from a more comprehensive value-based environment. Seamlessly aligning departmental workflows is QC7’s underlying framework designed for managing a myriad of specialized risk-based provider networks.
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SOC Certification Achievement
MedVision has successfully met the criteria outlined in the SOC (System and Organization Controls) audit for service organizations. This certification demonstrates MedVision’s adherence to rigorous standards for security, availability, processing integrity, confidentiality, and privacy.
As a service provider managing sensitive data and overseeing critical functions on behalf of clients, this certification underscores MedVision’s commitment to maintaining high standards of operational excellence and data security.
HITRUST Risk-Based 2-Year Certification Achiever
The Health Information Trust (HITRUST) is a standards organization dedicated to security, privacy, and risk management. They developed the HITRUST Common Security Framework (CSF), which assists organizations in maintaining a comprehensive and secure approach to HIPAA compliance and managing risks. HITRUST is widely recognized as the benchmark in data security and privacy.
Certified Member of HCAA
The Health Care Administrators Association is the nation's largest nonprofit trade association for third-party administrators, stop loss insurance carriers, managing general underwriters, audit firms, medical managers, technology organizations, pharmacy benefit managers, brokers/agents, human resource managers, and health care consultants. HCAA has spearheaded the change of self-funding for more than 35 years.
Awarded by CIO Review
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MedVision was featured as one of the most promising healthcare solutions providers.
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