Admit scan powerpoint slides
•
1 like•957 views
AdmitScan is a proposed solution to address the issues caused by out-of-network healthcare services. It utilizes QR codes on member cards that can be scanned to immediately determine network status and provide network provider information. For out-of-network admissions, it allows expedited electronic repatriation to in-network facilities within 30 minutes through a secure website. This addresses inefficiencies and delays in the current phone-based process, while reducing costs for payers, providers, and consumers compared to out-of-network rates. The concept is modeled after membership verification in fitness and airline industries using barcode scanning.
Recommended
More Related Content
What's hot
What's hot (20)
Similar to Admit scan powerpoint slides
Similar to Admit scan powerpoint slides (20)
Recently uploaded
Recently uploaded (20)
Admit scan powerpoint slides
- 2. Healthcare consumers who seek treatment from doctors and facilities that aren't covered by their insurance plans routinely receive bills that are anywhere from 118 % to a whopping 1,382 % higher than what the federal Medicare system is billed for the same services
- 3. • Of this amount, over 40 billion dollars were uncompensated losses to hospitals, physicians and ancillary providers leaving unpaid medical bills the number one cause of consumer bankruptcy • Hospitals and physicians suffer billions of dollars in out-of-network payment defaults while insurers, ACOs, medical groups and IPAs incur costs which are 25% or greater than network care
- 4. Clare Krusing, a spokeswoman for AHIP, said that a report released in 2014 found that about 12 % of the 3 trillion in health claims were made for services obtained from out-of-network providers... approximately 360 billion dollars
- 5. • Consumers present to ER with member cards with no scanning capability • Hospitals take 2 to 5 days to notify payers and/or confirm if plan is out-of-network by phone or fax • No access to list of network hospitals/physicians or contracted services • No info on card that member belongs to medical group, ACO or IPA WHY ARE CONSUMERS RECEIVING OUT-OF-NETWORK CARE?
- 6. • Referred by physicians to out-of-network hospitals & physicians • Insurers, hospitals, MDs & ancillary companies negligent with keeping accurate, easily accessible list of their contracted providers • Consumers are not informed of out-of-network status BEFORE services are rendered
- 7. the fitness industry to confirm membership with a barcode scan the airline industry who provide iPhone QR code boarding passes or AdmitScan is a simple concept which is utilized by:
- 8. How AdmitScan Works & What It Does 1. Interface created with payer to create member QR codes 2. QR codes placed on member cards, key tags or iPhones 3. QR code scanned in hospital ER/Admitting or Physician Office 4. QR code immediately reveals if plan is in or out-of-network 5. Scan provides current list of contracted MD & ancillary srvcs
- 9. 6. AdmitScan’s VPN/RSA secure website connects all hospitals (in and out-of-network) 7. Secure website connects all hospitals directly to payer, providers and physicians 8. Notifies payer, ACO, medical group, IPA, hospitalist & PCP of ER visit or hospitalization in real-time 9. Allows OON hospital to send electronic request to listed area network hospitals 10. Area network hospital sends electronic acceptance with bed & physician assignment
- 10. Insurer System Secure VPN, RSA, Encrypted https and HIPAA Managed Servers SEARCH INTERFACE
- 11. ADMITSCAN SOLUTION Search ACCESS SECURE ONSITE ADMITSCAN WEBSITE SCAN QR CODE ON CARD, KEYTAG, SMARTPHONE or MANUAL SEARCH OR +
- 12. Benefit of Returning Out-of-Network Admissions to Network • Members charged avg $7000 to $12,000 PER DAY for facility charges • Members charged hundreds of thousands extra for non-contracted MDs • Insurers/Payers pay 25% or more for out-of-network care • OON Hospitals & Physicians suffer billions in consumer defaults
- 13. • Process disorganized and can take days to accomplish • Current delays of 2 to 5 days to confirm if plan is OON and/or to notify payer, ACO, med group or IPA of event • Members not educated by hospital regarding their financial responsibility • Insurer, Medical group or IPA case managers work through inpatient case managers/MDs attempting to coordinate a transfer. Must call multiple network hospitals and physicians to procure bed/MD Why Current Process of Returning Out-of-Network Admissions to Network Hospital/MD Unsuccessful
- 14. OON Hospital CMInsurer or IPA CM Network Hospital CM Multiple Network Hospitals Multiple Physicians Not Necessarily Network/IPA Treating MD OON Hospital OON Hospital CM Multiple Ambulances Not Necessarily Contracted Insurer CM CURRENT REPATRIATION PROCESS TEDIOUS, TAKES DAYS
- 15. AdmitScan 24/7 Repatriation Solution 5 Clicks, Less Than 30 Minutes • Immediately aware patient out-of-network in ER. PROMPT to assess for transfer • Patient deemed stable by MD to transfer, click on REPATRIATION BUTTON • Fill out brief clinical needs, click on MATCH • Plan matched to area network hospitals. Choose desired hospital, click SEND • Network hospital receives request, assigns bed/MD, clicks ACCEPT • Out-of-Network hospital receives assignment within minutes • Contracted ambulance BOOK online
- 16. OON Hospital CM Insurer CM Sends to Network Hospital CM Matched Network Hospitals IPA CM ADMITSCAN REPATRIATION Repatriation Electronic Clinical Needs/Request for Repatriation Click Accept Reject Reject Click OON Hospital CM Books Ambulance Assigns IPA MD Med Grp CM All Entities informed of Repatriation Progress in real-time with ability to communicate Priority Alert Click Hospital CM Repatriates in 30 minutes or Less Straight From Emergency Room 5 CLICKS or less, NO PHONE CALLS +
- 17. Healthcare Web-based Applications Our Technology Works For You www.medrok.com www.admitscan.com Ph: 310-525-9837