Affinite Utilization Managment vs Prior Authorization

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Affinite Utilization Managment

0 review

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Prior Authorization

5.0

1 review

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Product Description:

Simplify Utilization Management between providers, members, and care management. Affinitē UM leverages Intelligent Automation to streamline administrative actions so your team can operate at the top of their licensure.

About Vital Data Technology, LLC:

Vital Data Technology empowers health plans to continuously improve outcomes, accelerate compliance and control costs. Vital Data’s Affinitē™ platform unifies formerly siloed data and leverages artificial intelligence and machine learning to drive actionable interventions. The platform’s modules include: Affinitē™ PlanLink™ for real-time CareFlow™ automation and case management for stakeholders throughout the care continuum; Affinitē™ ProviderLink™ for prioritized, actionable patient interventions; MyVitalData™ for mobile app member engagement; Affinitē™ Quality for optimization of quality management and HEDIS® performance, and Affinitē™ Risk for Hierarchical Condition Category (HCC) risk adjustment.

Vital Data Technology is trusted by health plans nationwide across Medicare Advantage, Medicare, Medicaid, commercial and self-funded adult and pediatric populations and has received NCQA HEDIS® Certification for five consecutive years. For more information visit: www.VitalDataTech.com or call (866) 482-8399.

Product Description:

There’s a wealth of powerful data within your EHR—you just need real-time insights and seamless integration to make it actionable. Our Prior Authorization solution, powered by Waystar’s Hubble: - Automatically verifies, initiates, statuses and retrieves comprehensive authorization details - Enables efficient, intelligent automation by initiating authorizations at twice the speed of manual processes - Integrates directly with all major HIS and PM systems - Provides end-to-end authorization platform, including authorizations submissions for unscheduled admissions, as well as auto-generating ABNs or Notice of Non-coverage forms for Medical Necessity - Adapts to constantly shifting payer rules and requirements - Was built and is maintained by our in-house team of experts

About Waystar:

Waystar delivers innovative technology that simplifies and unifies healthcare payments. The company’s cloud-based platform helps healthcare providers across all care settings streamline workflows, improve financial performance and bring more transparency to the patient financial experience. Waystar solutions have been named Best in KLAS or Category Leader by KLAS Research 16 times (across multiple product categories) and earned multiple #1 rankings from Black Book. The Waystar platform is used by more than half a million providers, 1,000 health systems and hospitals, and 5,000 payers and health plans—and integrates with all major hospital information and practice management systems. On an annual basis, Waystar’s AI-powered solutions process $5B in patient payments, generate $4B in out-of-pocket estimates and process claims representing approximately 40% of the U.S. patient population. For more information, visit www.waystar.com.

Compatibility level

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Clients

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Use Cases

Description:

Affinitē was able to identify members at risk of experiencing pre-term birth at 20 weeks of gestation. This enabled earlier intervention by Care Management and reduced the risk of complication and lowered overall costs.

In this group, over 10% of the members identified had costs associated with pre-term birth of over $500,000.

Pediatric use cases:

None provided

Users:

Proactively identify members in your population via AI-modeling in order to intervene earlier in the treatment process and positively impact their health outcomes.

Description:

With over 300+ payers and a broad array of deployable service lines and patient types, we provide a full cycle automation solution for prior authorization: from pre-scheduled prior auth submission, status checking and denial prevention worklist alerts, as well as medical necessity verification and notification of admission.

Pediatric use cases:

None provided

Users:

Pre-service financial clearance teams, auth cert teams, any prior authorization staff doing medical necessity as well as authorization for services at acute care facilities or OP areas.

EHR Integrations

Integrations:

None provided

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

None provided

Hardware Compatibility:

None provided

Integrations:

None provided

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

None provided

Hardware Compatibility:

None provided

Client Types

None provided

Pediatric Hospitals

Academic Medical Centers

Accountable Care Organizations

Rural Hospitals

Small Medical Facilities

Large Medical Facilities

Medium Medical Facilities

Extra Large Medical Facilities

Differentiators

Differentiators vs EHR Functionality:

None provided

Differentiators vs Competitors:

None provided

Differentiators vs EHR Functionality:

Many hospitals, health systems, and IDNs have invested in billion dollar EMR/EMRs which are an extraordinary vehicle for clinical and billing functions -- but lack the ability to elevate automation in key business areas such as prior authorization. This is due to their lack of payer connections and the absence of advanced intelligent software. Together, Waystar brings the intelligence that powers today's EMR/EHR platforms and automation efforts.

Differentiators vs Competitors:

With nearly a decade in the business of automating prior authorizations, we are known for our internal expertise when it comes to payers, process change, and technology. We believe pushing the envelope in know-how across all 3 is what gives our clients the edge on automation. With more payer connections, more relationships with payers, and greater flexibility in accessing payer data we can access the best and most timely data. We not only seamlessly integrate with EPIC but offer full-stack integration capabilities or a powerful stand-alone application -- all because each patient access team is different. And powered across our Hubble platform (a blend of RPA, machine learning, NLP, and advanced auth rules) we are well positioned to power your automated enterprise.

Keywords

prior authorization,automated workflows,workflow optimization,automation,transparency

automation,intelligent automation,prior authorization,ai,rpa,operational effiency

Images

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Videos

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Downloads

https://insights.vitaldatatechnology.com/vital-data-technology-wins-healthcare-innovation-award-for-2022

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Company Details

By Vital Data Technology, LLC

By Waystar

Founded in 2000

Visit Website

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