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.
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2. TELEHEALTH PROVIDER ENGAGEMENTOur 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.
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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.
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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
WE HAVE EXPERIENCE WORKING WITH
HOSPITALS AND CLINICS
RISK ADJUSTMENT PROGRAM IMPLEMENTED AND MANAGED |
PHYSICIANS AND RESIDENTS
TRAINED IN CMS GUIDELINES FOR DOCUMENTATION |
PROVIDER COMPLIANCE
WITH OUR RISK ADJUSTMENT PROGRAM AT EVERY SITE |
