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Description
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Clients
Use cases
EHR integrations
Client types
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Jump to:
Categories
Solutions
Description
Compatibility Level
Clients
Use cases
EHR integrations
Client types
Differentiators
Keywords
Media
Company details

Categories

Solutions

Description

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:
Obtaining pre-authorizations without delay is essential to both preventing unnecessary delays in care and ensuring accurate reimbursement for services provided. But there are multiple challenges to administering an efficient, effective pre-authorization program, including: • Recruiting and retaining staff who have both clinical and revenue cycle expertise • Dedicating resources to stay up to date on complex, evolving guidelines and payer-specific requirements, and to manage payer responses • Lack of a consistent, technology-enabled workflow An Efficient Solution: Our Authorization Management Services staff manages pre-certification and authorization needs for inpatient and outpatient diagnostic and therapeutic services. We also provide comprehensive concurrent or retrospective inpatient authorizations after admission. Our solution includes: • Authorization Experience and Expertise – Our services are provided by clinicians (nurses or allied health depending on client need) who have specialized education in authorization requirements and commercial screening tools. Our team members average more than five years of clinical and authorization experience, stay up to date with training and compliance, and are dedicated to helping ensure that no part of your authorization request slips through the cracks. • A Centralized and Streamlined Technology Process – Our team leverages a centralized system to accelerate payer response, with processes that are efficient and repeatable. We incorporate robotic-process automation to assist with account statuses and system updates. • Thorough Authorization Clinical Review – Our team reviews each medical record, focusing on payer-specific requirements and obtaining authorization for services scheduled or rendered. We stay abreast of changes to Medicare, Medicaid, and commercial payer guidelines. • A Focus on Reducing Authorization-Related Denials – We take a holistic approach to authorization, which includes working auth-related denials. We review denied admissions, days, and services, and complete all necessary steps for reconsideration and appeal requests. Our denial workflow is customized so that we can pair expertise to the type of denial; for example, leveraging technical versus clinical staff depending on the reason for denial. • Detailed Performance Reporting – We provide detailed performance reporting that includes a month-over-month view of account activity including: √ current status √ completion percentages √ approval percentages
About Change Healthcare:
Change Healthcare is inspiring a better healthcare system. We are a leading independent healthcare company that provides data and analytics-driven solutions to improve clinical, financial and patient engagement outcomes in the U.S. healthcare system. Our comprehensive suite of software, analytics, technology-enabled services and network solutions take costs out of the healthcare system by driving improved results in the complex workflows of payers and providers by enhancing clinical decision-making and simplifying billing, collection and payment processes, and enabling a better patient experience. We are creating a stronger and more efficient healthcare system that enables better patient care, choice, and outcomes at scale.

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:

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Pediatric use cases:

None provided

Users:

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EHR Integrations

Integrations:

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EMR Integration & Relevant Hardware:

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EMRs Supported:

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Hardware Compatibility:

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Integrations:

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EMR Integration & Relevant Hardware:

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EMRs Supported:

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Hardware Compatibility:

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Client Types

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Differentiators

Differentiators vs EHR Functionality:

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Differentiators vs Competitors:

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Differentiators vs EHR Functionality:

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Differentiators vs Competitors:

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Keywords

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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Alternatives

Company Details

Founded in 2007

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