HHAeXchange Recognized for leadership in Fraud & Abuse Detection/Prevention Category; also takes “Best in Show” honors in “Fiercest Product/Service” Category
[Long Island City, NY] – [Dec 16, 2015] – HHAeXchange announced that it has been recognized by this year’s Fierce Innovation Awards: Payer Edition, a unique awards program from the publishers of FierceHealthPayer and FierceHealthcare. HHAeXchange received top honors in the “Fraud & Abuse Detection/Prevention” category, as well as an overall award of “Best in Show: Fiercest Product/Service.”
The Fierce Innovation Awards recognize pioneering technologies and solutions that will catapult the health payer industry into exciting new realms. Finalists were chosen by a distinguished panel of executives from major health plans. A complete list of judges can be found at https://www.fierceinnovationawards.com/healthpayer/2015#our_judges.
All applications were evaluated based on the following criteria: technology innovation, financial impact/value, competitive advantage, member experience/member outcomes, market need, and overall fierceness and innovation. Finalists were selected based on calculation of the judges’ scores in each area.
HHAeXchange is being recognized for its innovative, industry-leading Payer Management Solution.
“We are pleased to hear the news of this prestigious recognition, as we are striving to change the game for Payers and home health agency providers by providing a ‘single source of truth’ for Payers supporting long term services and supports (LTSS) and home and community based services (HCBS),” says Greg Strobel, President. “This is a tribute to our dedicated team and their commitment to continually raise the bar on technology innovation. A big thanks to the publishers of FierceHealthPayer and FierceHealthcare for recognizing our solution and our contribution to Payers nationwide.”
About the Product
The HHAeXchange Payer Management Solution (Professional) is a shared software platform where Medicaid Payers/MCOs and their contracted network of homecare providers connect and communicate. Both sides like it very much.
“The Exchange” as clients refer to it, provides a whole new way in for Payers to collaborate with their network of home care providers to achieve increased operational efficiency, improved patient outcomes, reduced fraud and abuse and rock-solid compliance.
It provides real-time visibility into visit confirmation and caregiver/duty compliance, it enhances care coordination, streamlines the entire billing process and offers an audit trail of all communication between the Payer and its homecare providers.
The solution has been proven with Payers who have reported increased workflow efficiencies, reduced hospital readmissions and elimination of fraud, waste and abuse. Payers appreciate the ability to see operational, financial, and clinical trends across their provider base including their best performing home care agencies.
With the HHAeXchange Payer Management Solution, Payers gain:
- real-time visibility to monitor service delivery
- a platform that enables real-time intervention management
- invaluable network performance statistics and real time alerts
- the ease of referring new cases to the home care provider network with electronic broadcasting
- full compliance at the visit, caregiver and duty level
- reduction of denials and claims processing effort
The Exchange does not replace any existing systems, only enhances them. The ROI is virtually immediate and can be quite substantial. Per member/per month (PMPM) Savings $$ are driven from:
- Payment Integrity / Reduced fraud and abuse
- Reduced denials and associated claims processing expense
- Streamlined Referral/Case Placement and Acceptance
- Streamlined Care Coordination / Case Management
- Reduced IT expense
Electronic visit verification (often referred to as “EVV”) is a method used to verify home healthcare visits to ensure patients are not neglected and to cut down on fraudulently documented home visits. The HHAeXchange Payer Management Solution has EVV built in and includes three options for careworkers to record visits: patient’s phone, FOB device or GPS mobile application. The Payer Management Solution electronically verifies when home health service visits occur and documents the precise time service provision begins and ends. Exception scorecards are popular and dashboard reports demonstrate total critical and non-critical exceptions, reason codes (for example if a shift started outside the home, phone line not working or if patient refused caregiver use of phone), missed visits and unbilled visits for example.
The Clinical Pathways module can be added on to help Payers proactively manage the most costly and complex patient populations in real time. Developed by a team of clinicians in collaboration with payer clients, the home care community and IT innovators, Clinical Pathways enables more robust care coordination and case management, captures decline in real-time. The results include dramatic reductions in re-hospitalizations, significant savings to Payers and improved patient outcomes.
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