What You Should Know: Strategies employed by payers, provider-sponsored health plans, and provider organizations are starting to become more proactive, and the need for solutions with prospective, predictive capabilities is rising. Additionally, amid rising healthcare costs and economic uncertainty, organizations are looking for solutions that deliver more for less.A new KLAS report examines risk adjustment vendors’ abilities to drive outcomes and value, their prospective capabilities,
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Talix
Edifecs Launches Solution to Automate Prior Authorization at the Point of Care
What You Should Know: - The full automation of prior authorization at the point of care leads to improved member experiences, enhanced outcomes, ongoing compliance, and reduced administrative burden. Edifecs’ automated prior authorization solution integrates with electronic health records (EHR) and leverages artificial intelligence (AI), natural language processing (NLP), and industry standards such as FHIR to instantly deliver authorization. - This innovation comes on the heels of
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Next Generation of Risk Adjustment: Uniting Health Plans and Providers
Up until now, risk adjustment has been addressed as a mechanism to accurately represent the overall risk profile of a health plan’s membership. A function that will still facilitate a health plan’s payment for taking on at-risk populations is about to go through its first major transformation – the use of risk adjustment data to drive value-based program initiatives. Now that the functional aspects
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Edifecs Acquires Talix to Expand Risk Adjustment Solution
What You Should Know: - Edifecs, a global health IT provider announced it is acquiring Talix, a SaaS IT company, to expand Edifecs’ reach in the encounter management and risk adjustment space. Financial details of the acquisition were not disclosed. - The integration of Edifecs’ and Talix’s technologies will create an expanded risk adjustment solution with critical workflows and insights that improve efficiencies and directly support payer and provider collaboration. Talix
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Talix Spins Off Healthline Network, Raises $14M for Patient Data Analytics
Talix, Inc., a health tech subsidiary of Healthline Networks, announced that it is spinning off as an independent company and has secured $14 million in funding led by Summit Partners. This capital will be used to fund the growth of the company’s core risk adjustment product, Coding InSight, and support the development of future applications in its planned suite of patient risk management products powered by Talix’s proprietary HealthData Engine. Dean Stephens will serve as the new Chief
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