FHIR has gotten a lot of attention in recent months due to the push for FHIR-based APIs under the new CMS-0057-F ruling in January for prior authorization and interoperability. Specifically, this pushed for greater data transparency and sharing for providers, payers, and patients, with the singular goal of making healthcare more efficient, accurate, affordable, and...
When it comes to the successful implementation and management of a medical management platform project, there are a lot of elements to consider. We recently sat down with Tracy Styles, Senior Director of Program Management, who walked us through the key considerations, best practices, and pitfalls to avoid. She’ll also share what makes VirtualHealth’s project...
As part of VirtualHealth’s continued innovation, our team has been hard at work to bring reporting, analytics, and insights to a whole new level. Get the inside scoop directly from Kelechi Erondu, Director of Analytics, as he walks through some of the new features and functions we have related to analytics and insights in the...
Why Payers Need to Start Solving for Prior Auth and FHIR Now Prior authorization APIs and FHIR® are a big deal right now. The recent CMS ruling in January has got a lot of payers thinking, “How do I get this accomplished?” and “Does my current UM platform support this?” With the new requirements for...
Health Management Reporting: Looking at HELIOS Reporting Options HELIOS offers a variety of reporting and analytics modalities. From dashboards and views to exportable Excel files and graphic charts, healthcare payers can leverage native reporting functionality and work with VirtualHealth to create custom reports, dashboards, and views as well. This helps organizations using HELIOS to get...
Prior authorization can cause serious issues for members and providers if processes are not properly architected by a healthcare payor. More than nine in 10 physicians (94%) reported care delays while waiting for health care insurers to authorize necessary care, a physician survey by the American Medical Association found. Eighty percent said prior authorization can...
A recent survey from Becker’s Healthcare and VirtualHealth revealed what healthcare payers really think about the current state of value-based care and care management. The results show key obstacles still exist.
When people have the knowledge, skills, and confidence to engage in their own health, better outcomes are much more achievable. According to the Centers for Disease Control and Prevention (CDC), this conclusion was based on a research review that linked better health outcomes to higher levels of activation (having the knowledge, skills, and confidence to...
The worst of COVID-19 may be retreating into the rearview, but the pandemic’s effect on general population health lingers. Whether it was limited access to care, fear of exposure, or tangential factors like lack of childcare, people of all ages and socioeconomic backgrounds put preventive care on pause. That has led to: Delays in care ...
Healthcare powered by predictive analytics is transforming the healthcare space. From enabling more accurate and proactive care delivery and better patient outcomes to streamlining provider processes and workflows. And with continued advances in machine learning, and healthcare technologies constantly honing the accuracy of predictive models and algorithms, it’s clear that the future of healthcare will...
