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Healthcare IT Vendors
EMRs & Clinical Apps
RIS / PACS, Medical Imaging Apps
HIS & RCM Apps
Health Plans and Managed Care
Hospitals and Medical Groups
Medical Device Companies
Health Information Exchange
Pharmaceuticals and Life Sciences
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Health Plans and Managed Care - Overview

 

Market changes of recent years, including the rise of consumer driven health plans, care management programs and new shared - risk models (ACO, bundled payments) have resulted in significant changes in application designed for health plans and payer organizations. Health plans and managed care market must constantly adapt to changing needs across all fronts in the healthcare industry and associated regulations (Meaningful Use, PQRS, HEDIS, PCMH, Value Based Purchasing).

 

CitiusTech’s expertise in health plans and managed care workflows and our global delivery model enable us to provide specialized and cost effective development, testing and implementation services. Examples of our services for the health plan and managed care market include:

 

  • Development of reporting infrastructure and technologies to help customers with P4P, NCQA/HEDIS, and other reporting requirements
  • BI-Clinical apps for health plans: Integrated clinical and financial analytics and reporting (including predictive analytics). BI-Clinical is NCQA certified for coverage of ALL 65 HEDIS 2013 quality measures
  • Support of NPI conversion for payers and clearing houses
  • Development and implementation for supporting claim attachments
  • Implementation support to payer applications (custom maps, business rules & companion guides)
  • Support for web-enabled revenue cycle transactions and workflows including HIPAA TCS (Transaction and Code-sets)
  • Integration with popular third party managed care and payer application platforms from McKesson, Trizetto, QCSI, Edifecs etc.

Please explore our health plans and managed care case studies section for further knowledge. To learn more, please contact us by email at info@citiustech.com or call us at +1 (877) CITIUS1.

 
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