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

Provider Outreach and Education Contract delivery and tracking up through execution Credentialing and Scanning of all contracts and relevant documents Demographic collection and continuing maintenance Network Development Team

YOU ALREADY HAVE A LOT TO DO LET EHS MANAGE THE NETWORK FOR YOU

WE CAN: Manage contracts

Medicare Based, % of savings or proprietary fee schedule contract terms Varying rates within the same Tax ID Support for varied network configurations (Provider Tiering etc.) Legal Compliance Flexible Database

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 crosswalk for ease of adjudication Secure ftp hosting Manage wrap network solutions if needed Act as payor portal to minimize time to process Fully Integrated Repricing Engine

YOU ALREADY HAVE A LOT TO DO LET EHS MANAGE THE NETWORK FOR YOU

WE CAN: Provide Customer Service

Payors Providers Patients

YOU

Concierge Customer Service

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 Payor Utilization Customized Reports Reporting and Analytics

YOU ALREADY HAVE A LOT TO DO LET EHS MANAGE THE NETWORK FOR YOU

WE CAN: Provide Payor and Prospect Support

Host Customized Directories Export Demographics Geo Analysis RFP Support Robust IT Services

LET US CLOSE THE CIRCLE FOR YOU

Employer Health System Or Community Providers Members TPA’s

Managed Care Solutions for the benefit

• f Everyone