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

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Categories

Solutions

Description

Product Description:

We offer both Medical and Pharmacy Covered Lives Dashboards to help you navigate challenges associated with an ever-changing payer coverage landscape. The tool allows you to: 

  • View lives at the granularity level you need – State or County
  • See the big picture via the interactive map, charts, and summary tables 
  • Dive deeper with filters and narrow down results by Payers, Plan Types, and States 
  • View all parent – subsidiary relationships 
  • Understand payer – PBM relationships 
  • Export a copy for offline use
About Policy Reporter:

Empower your teams with Policy Reporter's payer documents library, change alerts, and reserach tools. 

Healthcare providers face numerous challenges in navigating the complex U.S. healthcare system:​

  • Keeping up with evolving medical necessity criteria, coverage policies, and billing rules​
  • Understanding and complying with diverse payer policies and prior authorization across commercial and government plans​
  • Efficiently managing revenue cycle processes in a constantly changing reimbursement landscape​
  • Ensuring patient access to necessary care while meeting payer requirements​
  • Minimizing claim denials and optimizing reimbursement​

This causes challenges such as: ​

  • Interpreting and applying complex payer policies consistently across the organization​
  • Reducing administrative burden associated with prior authorizations and claim appeals​
  • Staying current with frequent policy changes that impact reimbursement and patient care​
  • Balancing compliance requirements with operational efficiency​
  • Maximizing revenue while ensuring appropriate utilization of healthcare services​

Policy Reporter empowers healthcare providers to address these challenges by:​

  • Delivering analyst-verified alerts for tracking policy changes customize to your specialties and payer mix​
  • Simplifying access to up-to-date coverage criteria, prior authorization and reimbursement rules​
  • Offering comprehensive research capabilities to comply with key contract and claims rules​
  • Supporting efficient revenue cycle management with targeted insights and tools​

Our solutions reduce administrative burden, streamline reimbursement-related research, and empower your entire team to make informed decisions that improve patient care and financial performance.​​

Product Description:

Whether utilizing a centralized call center or answering calls locally at the practice level, medical practices are overwhelmed by high call volumes, frequently for routine issues that are easily automated.

The consequence of the current state is that:

  • Patients are frustrated by lack of access.
  • Staff are frustrated by frustrated patients.
  • Your brand is suffering.
  • Highly trained staff are forced to handle low complexity issues distracting them from what is most important; providing exceptional care.

ActiumHealth uses conversational GenAI:

  • To answer all incoming calls to a practice.
  • To intelligently route calls to the correct destination.
  • To provide self-service transactions for appointment scheduling, prescription refill, medical records requests, bill pay, etc...
  • To filter out the 20-25% of calls that are spam, robo, and fax.
  • To provide detailed actionable insights into the needs of your patients and the performance of your practices in caring for people on the phone.
  • To improve your brand promise by providing a more consistent customer service experience for callers.

Easily and quickly integrated into your telephony technology stack, ActiumHealth is deployable in weeks, cutomizable for unique needs, and costs a fraction of a human phone operator. 

About ActiumHealth (Division of Syllable):

Syllable is a leading provider of healthcare contact center and medical practice automation solutions using conversational AI

Syllable's product, the Patient Assistant, is used by both hospitals and practices to intelligently route calls more efficiently and provide for automated transactions like appointment scheduling and prescription refill on the phone.


The Patient Assistant also provides rich insights into the end to end call journey for your patients. Current call center metrics are too focused on the micro engagement at the call center and fail to provide the full extent of operational difficulties patients experience on the phone. 

Syllable is used by health systems such as NewYork-Presbyterian, Houston Methodist, Parkview Health, Memorial Care and Honor Health to improve patient experience, enhance access and reduce the cost of delivering healthcare on the phone.

With 88% of patients engaging with hospitals and providers over the phone, why invest millions on your digital front door. Engage patients where they are, on the phone, with Syllable. We automate 50% of incoming phone volume on day one at the fraction of the cost of a human call center agent.


Syllable provides swift time to value with real ROI.

Compatibility level

Select which hospital or health system you work at and see a personalized compatibility level.

Clients

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Use Cases

Description:

Strategic Planning & Business Development Teams

Use Case: Your strategic planning team can use the dashboard to assess regional payer enrollment figures, helping identify high-coverage payers and geographic areas for potential expansion of service lines or partnerships. This data supports informed decisions on resource allocation and growth opportunities.

 

Contract Management Team

Use Case: Your contract managers can leverage payer enrollment data to prioritize contract negotiations with high-enrollment payers, ensuring they are focusing on payers that cover a significant portion of the local patient population. This helps secure better terms and expand patient access to your services.

  

Revenue Cycle Management Team

Use Case: Your revenue cycle team can use the dashboard to identify top payers by enrollment, helping to align resources and focus efforts on resolving issues with payers that represent the largest patient populations. This data-driven approach can streamline claims processes and improve reimbursement rates.

  

Population Health Management Team

 

Use Case: Your population health team can analyze payer enrollment data by plan type and geography to better understand the coverage landscape and identify gaps in patient access. This information can be used to tailor care coordination efforts and improve patient outcomes by targeting interventions based on coverage trends.

 

Provider Relations & Network Development Team

 

Use Case: Your provider relations team can use enrollment figures to evaluate the network strength of key payers in specific regions. This data helps assess which payers to engage for network participation, ensuring alignment with those that have substantial patient coverage in your service areas.

Pediatric use cases:

Same application as above. 

Users:
  • Strategic Planning & Business Development Teams
  • Contract Management Team
  • Revenue Cycle Management Team
  • Population Health Management Team
  • Provider Relations & Network Development Team
Description:
  • Call center automation
  • Intelligent call routing
  • Automated FAQ
  • Automated scheduling
  • Automated prescription refill
Pediatric use cases:
  • Call center automation
  • Intelligent call routing
  • Automated FAQ
  • Automated scheduling
  • Automated prescription refill
Users:
  • Patients
  • Non-patient external callers
  • Internal callers

EHR Integrations

Integrations:

None provided

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

None provided

Hardware Compatibility:

None provided

Integrations:

Acute care EMR, Ambulatory EMR, ADT

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

Epic, Meditech, Allscripts

Hardware Compatibility:

Mobile / Tablet (native app), Mobile / Tablet (web optimized), Desktop

Client Types

Awards

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Differentiators

Differentiators vs EHR Functionality:

None provided

Differentiators vs Competitors:

None provided

Differentiators vs EHR Functionality:

We integrate with the EHR to provide transaction automation. The EHR is not a competitor.

Differentiators vs Competitors:
  • We meet patients where they are, on the phone.
  • 100% healthcare focused
  • We answer over 1M calls a month for our current partners
  • Real ROI for our partners
  • Successful integrations with EPIC, Alscripts, Meditech
  • Dedicated senior executive who is responsible for your account from initial contact through implementation and beyond.

Keywords

Images

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Videos

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Downloads

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