Payers

Payers

For Each Other

With a fragmented EHR landscape, diverse ways of storing and classifying data in EHRs and lack of standard documentation between doctors, payers face a huge challenge when trying to get real-time feedback on clinical data quality across their provider network.

With FIGmd, payers can leverage specialty society defined clinical quality measures, comparisons with national benchmarks for provider tiering and combining this information with cost data for effective provider selection, referral management and network tiering.

In addition to provider network tiering, payers can leverage FIGmd for the following:

  • Provider value based payment program reporting
    • Support requirements for Value Based Payment (VBP) programs
    • Generate reports using clinical data from EMRs / EHRs
    • Ease the burden of reporting for providers
  • HEDIS Hub
    • Leverage the existing FIGmd provider network
    • Match health plan provider (and patient) chase list against existing network
    • Chase lists for HEDIS reporting, medical review, prospective risk adjustment, with no manual effort
  • Coding Optimization
    • Payers expect notification of certain activities through claims
    • Necessary G-codes and CPT II codes generated using EMR/EHR data
    • Codes sent back to practice management systems to be sent out on claims
  • Care Planning
    • Provide intervention messaging at the point of service
    • Gaps in care alerts generated using society defined quality measures
    • Deliver payer generated gaps in care and other predictive risk alerts