Closing the circle between Providers, Payors and Patients WHO IS - PowerPoint PPT Presentation

Closing the circle between Providers, Payors and Patients

WHO IS EVOLUTIONS HEALTHCARE SYSTEMS? Over the past 25 years EHS has evolved into one of the nation’s largest independently owned PPO networks with regional dominance in the state of Florida. EHS has taken this expertise in network development to create fully customized networks for Group Health and Workers’ Compensation based on our client’s needs and criteria. Through our own proprietary software Evolutions has a solution for all network and repricing needs from contracting through claims handling and repricing. Our software development team has created a robust yet flexible system engine adept at interpreting, calculating and repricing claims based on complex matching protocols and showcasing custom directories that effectively represent the most complex network tiering and benefit designs. Evolutions provides a comprehensive suite of healthcare management solutions and claims processing services including EDI, customized directories, out of network savings solutions, analysis, reporting and more!

YOU ALREADY HAVE A LOT TO DO LET EHS MANAGE THE NETWORK FOR YOU WE CAN: Handle the entire contracting process Contract delivery and tracking up Provider Outreach and Education through execution Network Development Team Credentialing and Scanning of all Demographic collection and contracts and relevant continuing maintenance documents

YOU ALREADY HAVE A LOT TO DO LET EHS MANAGE THE NETWORK FOR YOU WE CAN: Manage contracts Medicare Based, % of Varying rates within the savings or proprietary fee same Tax ID schedule contract terms Flexible Database Support for varied network configurations Legal Compliance (Provider Tiering etc.)

YOU ALREADY HAVE A LOT TO DO LET EHS MANAGE THE NETWORK FOR YOU WE CAN: Work with multiple payers and their plan designs Creation and Management of EDI Bridges including code Secure ftp hosting crosswalk for ease of adjudication Fully Integrated Repricing Engine Manage wrap network Act as payor portal to solutions if needed minimize time to process

YOU ALREADY HAVE A LOT TO DO LET EHS MANAGE THE NETWORK FOR YOU WE CAN: Provide Customer Service Payors Providers Concierge Customer Service YOU Patients

YOU ALREADY HAVE A LOT TO DO LET EHS MANAGE THE NETWORK FOR YOU WE CAN: Provide feedback on network performance Gap Analysis Claims Analysis Reporting and Analytics Payor Utilization Customized Reports

YOU ALREADY HAVE A LOT TO DO LET EHS MANAGE THE NETWORK FOR YOU WE CAN: Provide Payor and Prospect Support Host Customized Export Demographics Directories Robust IT Services Geo Analysis RFP Support

LET US CLOSE THE CIRCLE FOR YOU Employer Health System Or Community TPA’s Providers Members Managed Care Solutions for the benefit of Everyone