HEALTHCARE CLAIMS RECOVERY
GIVES INFORMATION ON WHAT WAS PAID AND WHAT WAS NOT ON CURRENT BILLING CYCLE.
We have several data bases which we process the current billing cycle through, that will not only give us the information for what was paid through that current billing cycle but it will also provide us what was not PAID. We then sequence the proper procedure codes and resubmit the billing to either the Hospital or the Clearing House direct.
SERVICE LINES ANALYTICS
CONSOLIDATES INPATIENT AND OUTPATIENT SETTINGS INTO ONE HOLISTIC REVIEW MAPPED TO APPROPRIATE SERVICE LINES
Because outpatient encounters – unlike inpatient encounters – are typically reimbursed by insurance companies based upon the specific procedures performed, drugs administered, duration of visit, and other factors, and because multiple procedures might be performed or drugs administered over the course of a single encounter, there has been no need – from a billing or reimbursement perspective – to develop an outpatient “grouping” methodology that summarizes the primary focus of those encounters. Thus, no means has existed for readily summarizing those encounters or assigning them to service lines. Historically, for reporting purposes, outpatient encounters might have been generalized based on the associated physician’s specialty or use of some other broad brush. However, as health care delivery for all but the sickest of patients shifts more and more often to an outpatient setting, it is becoming increasingly important from a business planning perspective to accurately understand the composition of outpatient care. Service line performance and opportunities must be evaluated from a holistic perspective, considering both inpatient and outpatient settings. This only becomes possible when outpatient encounters can be readily summarized and mapped to appropriate service lines.
SUPPLY CHAIN ANALYTICS
PROVIDES A KNOWLEDGEABLE REPRESENTATION FRAMEWORK OF DATA PROCESSING AND ANALYTICS WORKFLOW
Hamlet Healthcare Systems provides a natural and convenient way to encode contexts among seemingly disparate data sources and models while providing a common framework to house and represent all forms of physical activities, events, and entities, and simultaneously provide a means to transparently add meta-information to any single piece of data or data A key novelty of the tool is that one no longer needs to search for identifying any form of associations amongst the data items as all such associations are maintained as tokens, coincident with the data items related. Thus, they can be obtained merely by referencing the items of interest and using the tokens found therein to directly (through a contextual mapping algorithm) index the referenced items in the storage medium. This novelty, coupled with other associative memory functionality, provides the capability for real-time correlation of semantic information enabling one to build an adaptable and evolvable knowledge representation framework directly within the tool itself.
PHARMACEUTICAL PATIENT PORTAL
ALLOWS DOCTORS TO IMMEDIATELY RECEIVE CONFIRMATION REGARDING AUTHORIZATION OF PRESCRIPTIONS.
Through Hamlet Healthcare Systems Patient Portal, the Hospital or Doctor will immediately receive confirmation regarding the authorization on any Pharmaceutical prescription.