3 KEY AREAS OF SOLUTIONS
1. IDENTIFY HIGH RISK MEMBERS
Our Medilytics analytics engine can help health plans and networks identify patients who are at particularly high-risk for COVID-19 and missed HCCs. Our internal team of physicians pre-review these members to identify a list for telehealth intervention.
2. TELEHEALTH PROVIDER ENGAGEMENT
Our MD provider liaisons work directly with telehealth providers, creating a seamless, member-specific CDI integration process, ensuring providers are alerted to HCC gaps prior to a scheduled telehealth visit. Our MD provider liaisons make themselves available on call for any questions telehealth providers may have confirming real-time HCC captures.
3. OPTIMIZING FINANCES
Mediscore wants health plans to continue to invest directly in patient management so much so that Mediscore absorbs the upfront costs of our services. During a time of increased utilization this opens up cash flow while ensuring accurate risk adjusted reimbursements from CMS.
EXPANSION OF MEDICARE TELEMEDICINE UNDER RULE 1135
Centers for Medicare & Medicaid Services (CMS) has broadened access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their doctors without having to travel to a healthcare facility. CMS is expanding this benefit on a temporary and emergency basis under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act. Key exceptions to note for the duration of COVID-19 Public Health Emergency include:
- At-Home Telemedicine is permissible
- Providers *may* see new patients via telemedicine
- Good Faith HIPAA Waiver