Certified Electronic Health Record Technology (CEHRT)
Integration of electronic health records improves oversight and optimizes reimbursements
PLEXIS’ clinical, financial, and administrative payer platform can seamlessly integrate certified electronic health record technology (CEHRT) to create a wealth of benefits for payers, providers, and patients. CEHRT encompasses qualified electronic medical records (EMRs), sometimes called electronic health records (EHRs). CEHRT is critical for coordinating care and measuring outcomes so that payers can contain costs and enhance quality of care. Beginning in 2017, payers with Medicare lines of business can avoid penalties and optimize reimbursements by implementing CEHRT.
PLEXIS’ CEHRT Integration Empowers:
- Payers delivering a diversity of care such as: Tribal healthcare, Government healthcare, Specialty carve-outs, Payer-provider collaboration, and more
- Payers with Medicare lines of business. Avoid a 4% cut in Medicare payments and optimize the full potential for reimbursements
- Significant savings from clinical and administrative efficiencies
- Care coordination and enhanced oversight over patients’ holistic health
- Extended cost savings through the complete range of electronic data interchange (EDI) solutions including portal technology and EDI services
- Cost containment through the automation of complex benefit calculations to drive high auto-adjudication rates and minimize the risk of paying claims incorrectly. Payers recover significant savings and reduce utilization costs by leveraging PLEXIS’ real-time alerts, automatic audits, health risk assessments (HRAs), responsive reporting, and more
- Extended savings via PLEXIS’ apps for care management, UM/UR, and disease management, providing a full toolset for medical management negotiations, data-driven utilization review, wellness services, and monitoring/management of high-dollar claims
- Return on Investment (ROI) by eliminating the high cost of manual data entry
Optimizing Reimbursements for MACRA
On October 14, 2016, the Centers for Medicare and Medicaid Services (CMS) released the final version of the physician quality payment reporting program under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The law goes into effect on Jan. 1, 2017, and it affects more than 600,000 physicians across the country.
