Avia Logo

Compare Products


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

0 review

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:

Our proprietary Health Fabric technology offers zero-waste data orchestration to protect your top and bottom lines. Seamlessly integrate disparate data sources and create a unified view of healthcare operations.

By breaking down data silos, Health Fabric enables:

• Real-time data synchronization across systems

• Enhanced data quality and consistency

• Improved interoperability between healthcare platforms and tools

• Faster, more accurate analytics and reporting

About MedeAnalytics:

Founded in 1993, MedeAnalytics is an innovation-focused company. Over the past three decades, we have worked tirelessly to reimagine healthcare through the power of data—and helped thousands of organizations achieve their potential along the way.

Leveraging state-of-the-art analytics and data activation, MedeAnalytics delivers actionable insights that support payers, providers, employers, and public entities as they navigate the complex healthcare landscape.

Using artificial intelligence and machine learning alongside the most advanced data orchestration in the industry, we empower organizations to optimize their resource allocation, experience superior patient outcomes, and achieve population health management goals.

Compatibility level

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

Clients

Select which hospital or health system you work at and see the client list

Product Capabilities

Once your data has been ingested, cleansed and normalized in our secure platform, all clinical, financial and operational data is available to your organization in an enterprise single source of truth. Utilize our AI-powered, Integrated Analytics solutions and Data Science Factory™ to transform operations and streamline workflow, addressing complex business needs such as: • Identify and address revenue leakage points, recapturing lost income • Streamline billing processes, accelerating reimbursement cycles • Predict and prevent claim denials, improving first-pass resolution rates • Implement data-driven strategies to enhance overall financial performance • Quantify the quality of pre-service activities and increase POS collections • Gain visibility into the direct drivers of cost of care to optimize performance and improve margins on a continuous cycle

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:

None provided

Pediatric use cases:

None provided

Users:

None provided

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, Ancillary EMR, ERP system, Patient portal, Pop health platform, Home health, Behavioral health, Community based organizations, ADT, Access +/or revenue cycle, Credentialing, Website / public online sources, Other

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

Epic, Cerner, Meditech, Allscripts, NextGen, athena, GE, eClinicalWorks, McKesson, Other, Allscripts/Eclipsys, Athenahealth, Azalea Health/Prognosis, CPSI, Evident, Healthland, MEDHOST, MedWorx, QuadraMed, Self-developed, Would prefer not to disclose, Point Click Care

Hardware Compatibility:

None provided

Client Types

Differentiators

Differentiators vs EHR Functionality:

None provided

Differentiators vs Competitors:

None provided

Differentiators vs EHR Functionality:

The Health Fabric is a data powerhouse that integrates and unifies millions of clinical, financial and patient datapoints to enable accurate, reliable and secure information exchange, across all data sources. This Unified Data Exchange is designed to integrate with every major EMR, payer, clearinghouse, bank and other data sources. This fluid transfer of data has hundreds of pre-built connections to integrate with multiple data sources, helping to simplify implementation, uphold data integrity and facilitate a seamless connection to the source of truth

Differentiators vs Competitors:

Specifically built for healthcare, MedeAnalytics Health Fabric delivers unparalleled power and scalability in data activation. This robust foundation empowers clients to fully harness their data assets within a unified and secure environment, seamlessly connecting multiple data sources and integrating with other solutions, ensuring rapid information delivery at the point of care.

Keywords

Images

1 of 1

edit-media
Covered Lives tool .png

1 of 2

edit-media
HealthFabric-Health-Care-770x300-1.webp

Videos

No videos provided

1 of 1

edit-media

Downloads

No content provided

media thumbnail
https://hitconsultant.net/2025/04/01/medeanalytics-launches-health-fabric-on-snowflake-ai-data-cloud/

Alternatives

Company Details

Founded in 1993

team illustration
Share your product comparison with your collegues.

Need help narrowing down products?

Add more criteria to see your compatibility level for every vendor. It only takes a few minutes, just create a free account to get started.
back to top