CitiusTech Introduces Out-of-Area Coverage Feature for BlueCross BlueShield Health Plans

Princeton, N.J. (August 25, 2020) - CitiusTech, a leading provider of healthcare services and solutions, announced today that its SCORE+ platform has launched support for Out-of-Area (OOA) record collection projects specific to Blue Health Plans. It follows the recent launch of a pilot program by the Blues Association, where Blue plans in different states can collect medical records on behalf of each other – for HEDIS, Stars, and risk adjustment needs.

CitiusTech’s SCORE+ is the first solution to launch a dedicated module for Out-of-Area coverage. It now has an enhanced Medical Record Review (MRR) module that supports standard file formats exchanged by Blue plans. It also includes ready-to-use workflows to streamline Out-of-Area chart collection, along with pre-built reports that Blue plans can share with each other to track progress of such projects.

“Out-of-Area provider collaboration is usually a high cost, time-consuming and low success rate process,” says Jeffrey Springer, Senior Vice President and Head of Product Management at CitiusTech. “There is a clear need for an automated and standards-driven approach with unique workflows and reporting needs, which are all managed manually today. SCORE+ now fulfills this need.”

The new OOA feature in SCORE+ is a first-of-its-kind capability that focuses on simplifying payerprovider collaboration across states, as per the mandate by the Blue Cross Blue Shield Association in December 2019. According to the mandate, Blue plans can request and receive OOA member information from the corresponding Blue plan in other states, without having to connect with providers in those states.

The OOA program is currently being run in a pilot phase, with 5 Blue plans, but is eventually expected to be rolled out across a majority of Blue plans nationwide.

About CitiusTech
CitiusTech is a specialist provider of healthcare technology services and solutions to healthcare technology companies, providers, payers and life sciences organizations. With over 4,000 professionals worldwide, CitiusTech enables healthcare organizations to drive clinical value chain excellence – across integration & interoperability, data management (EDW, Big Data), performance management (BI / analytics), predictive analytics & data science and digital engagement (mobile, IoT). CitiusTech helps customers accelerate innovation in healthcare through specialized solutions, healthcare technology platforms, proficiencies and accelerators. With cutting-edge technology expertise, worldclass service quality and a global resource base, CitiusTech consistently delivers best-in-class solutions and an unmatched cost advantage to healthcare organizations worldwide.

CitiusTech Media Contact:
CitiusTech
Somdipto Ghosh
Corporate Marketing
somdipto.ghosh@citiustech.com