Healthcare
eMids services include various solutions for all stakeholders in the healthcare industry
Industry Specific Services:
Payer
The changing face of the health insurance industry, evolving technologies, presence of legacy systems, and need for better economic efficiencies demand for an co-sourcing partner with significant knowledge and expertise in the healthcare industry and more importantly, payer applications. The team at eMids has years of experience in working at varying technology and operational tasks for our payer client base.
At eMids, we offer both Payer Solutions and Payer Services for Information Technology and Operational needs to cover the implementation, development and maintenance phases of payer systems.
eMids Payer Solutions
Enrollment solutions
Automating enrolment processes for both commercial and medicare plans can bring about significant reductions in enrolment costs. Standardizations by HIPAA help in developing electronic solutions and “e-enrolment” is being adopted aggressively by the industry today. eMids has valuable technical and functional expertise to assist you with your “e-enrolment” initiatives.
NPI Crosswalk
Addressing NPI is of high importance as it affects core business processes such as billing and claims adjudication. eMids has developed a NPI Cross walk solution that:
- Helps you de-duplicate your provider information
- Dynamically and accurately match Legacy ID to NPI through a systemic approach
- Quick and easy provider search
- Capture and track other attributes of the provider through taxonomy codes
- Reporting
Overall, our solution is quick and easy to deploy and helps you better manager your provider relationships.
eMids Payer Services
Data warehouse, Reporting & Business Intelligence
All high growth payers commonly face the scenario of disparate databases and systems, duplicate data and the urgent need to generate accurate enterprise level reporting and data analysis capabilities. With eMids extensive experience in extraction, transformation and loading using multiple technologies and techniques, your data warehouse and business intelligence needs can be met quickly. We partner with you to allow you to focus on interacting with your customer re their reporting and information needs while we manage the implementation.
Claims adjudication
eMids helps several payers by maintaining their claims adjudication system. We are instrumental in helping our customers achieve a high rate of auto adjudication through tactical and strategic enhancements to the system. We have experience with several claims systems including facets, MHC etc.
Analytics
Of high importance to insurers is the ability to predict risk for individuals and populations. eMids has a highly qualified analytics team that can help you model your data to achieve such predictive capabilities.
Medicare Operations
eMids can help its payer customers achieve higher data quality on their medicare products. We routinely help our customers perform data analysis and generate reports to comply with medicare regulations.
Care Management
Care management function is intended to provide a unified view of a member: medical claims, pharmacy, disease management, interventions, outcomes, communications and reporting. eMids can assist with developing a care management platform or implementing and supporting a third-party care management package.
Vendors
The healthcare industry forms a highly competitive landscape for vendors with software products for payers and/or providers. Not only is the need to differentiate products critical, there is also an emerging need to differentiate by adopting modern technology platforms and cost-contained product engineering models. Our vendor customers include clearing houses, disease and wellness management companies, transaction services, EMR/CHR/PHR providers, TPAs, software product vendors, SaaS providers etc.
eMids addresses the common business challenges Vendors face:
- Adopt agile product engineering methodologies to reduce time to market and maximize product feature coverage
- Migrate from legacy to modern technology and platforms while maximizing the legacy investments
- Adopt cost-contained product maintenance models
- Invest in independent third-party testing & QA of your product to deliver the ‘high quality’ promise you made to your customers.
- Readiness assessment to use offshore models
- System integration to client base or partnering software ISVs
- Go-Live support and maintenance
Provider
Providers of care form the essential core of our healthcare system. They have the human responsibility of receiving patients, performing diagnosis, offering consultation, rendering treatment and the lifecycle to fully healing the patient. This comes with its own set of compliance challenges and ever growing need to ensure proper and accurate patient care.
eMids assists providers in the following areas:
Technology Services
eMids offers various services for technology which include a full range of Information Technology services.
Medical Coding
eMids’ certified Medical coders can remotely connect into the provider’s EMR/Document imaging platform to review charts and code per guidelines. eMids signs up for SLA driven fee schedules where the entire fee is at risk. In other words, the customer pays only if they work product meets the established quality criteria
Highlights of this service:
- Service Level Agreement (SLA) driven fee schedule with all fee at risk
- Certified coders
- Secure remote connectivity into the provider's EMR/Imaging system
- Support all types of charts