Optum Patient Care Management Integrations

The Avalon Laboratory System, which is sophisticated and HIPAA compliant, was specifically designed to manage production and billing requirements for clinical, esoteric and toxicology labs. Computer Service & Support (CSS) developed this modular laboratory information system that offers a variety of features for reference laboratory automation. This solution also includes modules for microbiology and pain management, toxicology, scheduling, remote laboratory, SQL Access and electronic medical records. It also offers pharmacogenomics and revenue cycle management.

InvisaClaim stands out as the premier all-in-one revenue platform, leveraging AI to enhance Revenue Cycle Management by streamlining denial management, appeals, prior authorizations, and compliance with the No Surprises Act for billing companies and RCM teams. Users can upload or utilize a live feed to submit denial letters or 835 ERAs, allowing the AI to swiftly extract essential patient information, CARC/RARC codes, CPT/ICD-10 codes, amounts, and deadlines, subsequently generating tailor-made appeal letters for over 30 payers in just one minute. The system comprises various modules, including a Denial Workbench, NSA/IDR for eligibility verification and QPA capture, Prior Authorization, Pre-Check AI, A/R aging, NPPES NPI verification, deadline alerts, and a comprehensive audit trail. In addition, InvisaClaim seamlessly connects with your clearinghouse and EHR systems, boasting integration partnerships with notable entities such as Change Healthcare/Optum for features like ERA, eligibility checks, claim status, and prior authorizations, while Availity integration is currently underway and Waystar facilitates Provider Access Requests. Furthermore, strategic EHR collaborations with Athenahealth are in the works, alongside the implementation of a FHIR R4 layer for interoperability with Epic and Cerner systems, ensuring a robust and flexible service. With a commitment to security, InvisaClaim adheres to HIPAA compliance and holds SOC2 certification, demonstrating its dedication to maintaining the highest industry standards.

CareBridge, developed by Med Tech Solutions, is a certified platform for EHR integration that is neutral to vendors. It enhances the ease of data exchange, management, and accessibility among diverse healthcare organizations and information systems by connecting Electronic Health Records (EHR) with other health technology infrastructures. Acting as a central hub, CareBridge ensures that messages can transition smoothly between various sources and destinations. Its comprehensive, web-based management console provides organizations the ability to monitor the status of interfaces, thereby reducing the likelihood of integration downtime. Supporting multiple data formats and standards like HL7, JSON, XML, flat files, and EDI/X12, the platform guarantees compatibility across a broad spectrum of systems. CareBridge offers adaptable deployment alternatives, including on-premises setups, cloud hosting, or an Integration Platform as a Service (iPaaS), making it capable of evolving alongside your organization’s needs. Furthermore, its robust capabilities position it as an essential tool for improving interoperability within the healthcare sector.