AHIN. ahinservices.com WEB.

Transcription

1 AHIN Advanced Health Information Network (AHIN) offers real-time functionality for health care professionals, delivering current patient information while helping providers improve business function efficiency. The secure portal seamlessly connects health care professionals with a real-time repository for: Eligibility Claims Claims status Remittance advice Fee schedules Claim-auditing tools Detailed reporting Inherent functionality includes claim submissions, claims status, patient eligibility and real-time error correction. Health care professionals can verify eligibility for the entire Arkansas Blue Cross and Blue Shield family of companies, and access key information such as deductibles, co-pay and stop loss/ coinsurance, based on type of service. Health Advantage BlueAdvantage Medi-Pak Medi-Pak Advantage Medicare BlueCard Additional benefits include: Claim submission integration (individual or batch) with delivery confirmation Direct Data Entry (DDE), allowing smaller practices/solo practitioners to create and submit HIPAA compliant electronic claims Secure transfer of import-ready records from provider to provider Claim-edit programs that enable the creation of sample claims to ensure the correct CPT/ICD9 correlation, reducing rejected claims. Code-specific inquiries based on coverage policies can also be conducted through AHIN

2 Personal Health Record (PHR) Participating members of the Arkansas Blue Cross and Blue Shield family of companies have access to their personal health record (PHR) through a secure website. The PHR includes information such as claims data, immunizations, chronic conditions, medications, and family and social histories. A behindthe-scenes, advanced-functionality rules engine displays real-time information. Physician benefits of PHR access: Delivers immediate, accurate information for emergency situations, referrals and new patient care Provides an invaluable tool for chronic disease management, medical history and medications Improves coordination of care between health care providers Enables providers to make the best possible health care decisions Enhances patient/provider relationship Improves overall patient care and health care outcomes Participation is automatic, but patients have the ability to opt out at any time.

3 Clearinghouse AHIN Professional Services can help you coordinate and consolidate your claims process. In addition to the features and functionality of AHIN, the clearinghouse services available through AHIN Professional Services are designed to address the daily tasks of claims processing. These services expand beyond the Arkansas Blue Cross and Blue Shield family of products, adding new levels of access to nationwide commercial payers, greatly reducing the administrative burdens associated with eligibility verification and claims. Business benefits include: Single point of contact for claims management Improved revenue cycle Secure, direct-to-payer, web-based electronic submissions Error elimination and increased staff productivity Claim submissions for all Arkansas Blue Cross and Blue Shield product families nationwide Electronic claims submission to outside participating public and private payers nationwide Elimination of manually preparing and submitting claims Batch submission Clearinghouse Plus Includes all Clearinghouse functionality, plus: Real-time electronic insurance eligibility and benefits verification Claims status Electronic remittance advice for public/private payers nationwide Immediate access to a host of claim tracking and reporting Corrective action tools

4 Integrated EHR Migrating from paper charts to an integrated electronic health record (EHR) and practice management solution can simplify business processes and improve overall patient care and safety. AHIN Professional Services has partnered with Greenway Medical Technologies, Inc., the industry leader for practice management and EHR technology. We offer their flagship solution, PrimeSUITE, which is a comprehensive EHR solution ideal for practices of all sizes and specialties. Patient and provider benefits include: Accurate and complete patient information Better care coordination and disease management Improved communication with patients and their family caregivers AHIN Professional Services aligns with your practice and guides you every step of the way, from initial assessment through implementation, training, go-live, customer service and support. Some providers may be eligible to participate in the EHR Incentive Program. To qualify, you must utilize a certified EHR and achieve meaningful use, which is defined by CMS and consists of objectives that must be met by the practice. AHIN Professional Services can assist your practice in achieving Meaningful Use in order to qualify for the incentive monies. According to CMS, more than $8 billion has been paid in EHR incentives in the past two years. PrimeSUITE can be implemented in two ways: Software as a Service (SaaS) With this model, the EHR application is hosted for your practice and assessed via the Internet or cloud. Since all users are on the same software and version, benefits include ease of administration, user compatibility and lower initial investment costs. AHIN maintains responsibility for server maintenance, back-ups and software updates. Client/Server Your practice houses both the server (hardware) and the EHR software. This option requires a higher initial investment but gives you more direct control over your computing environment. Your practice maintains the hardware and software, and is responsible for troubleshooting, data back-up and security. An AHIN Practice Solutions Analyst will meet with your practice to identify your unique needs and make specific recommendations on the best solution for incorporating an EHR system into your practice. Special financing options have been secured with BancorpSouth to assist qualified providers with funding the EHR software and hardware purchase. To learn more, visit

5 Total Practice Management AHIN Professional Services offers the full spectrum of practice management solutions, encompassing managed care issues, staffing challenges, rising costs, claims management and HIPAA compliance. You retain complete control, yet are no longer hindered by day-to-day administrative and operational tasks. AHIN Total Practice Management is your single source for: Integrated practice management and EHR systems Practice management Revenue cycle management Medical billing services Coding services Clearinghouse Credentialing Practice start-up or expansion Human resources Risk management While other practice management companies may charge a percentage of account receivables, AHIN Professional Services delivers fully integrated services, including practice management and EHR systems, with comparable pricing.

6 Consulting Services Physician practices face a broad range of operational and organizational challenges. AHIN Professional Services provides consulting services that help make administrative operations more efficient and effective. We will conduct an in-depth assessment of your practice, and work with you to establish objectives and develop a plan of action to improve your business operations. Assessment areas include: Office workflows Patient flow Billing and claims management Reimbursement analysis Documentation and coding Staffing Our custom recommendations will help you streamline your practice, reduce labor costs and overhead, and significantly improve your bottom line, all while enabling you to stay focused on patient care. Whether a short-term need or a long-term project, our in-office services help providers maintain higher levels of productivity and office efficiencies. Additional specialty services include: Front office training Internal customer service Mystery patient shopper Meetings and retreats

7 Infrastructure Services With the migration to EHRs and other computer based applications, your IT infrastructure is quickly becoming more critical to your daily practice operations. AHIN Professional Services can provide you with the assurance that your IT infrastructure is in top operating condition. Our team of IT experts is available to ensure your systems are properly maintained, keeping your critical computer systems, and your business, up and running. Our skilled IT staff will take care of your bits, bytes, servers and applications so you can focus on your core competency taking care of patients. Managed services our IT professionals will meet with you to determine your unique needs and tailor a support program that best meets those needs. We can manage all aspects of your network with remote network management. This will ensure systems operate at peak performance to minimize disruptions to your business due to network problems. Additional services include remote remediation (of most network issues), back-up verification, security management, antivirus management, performance reviews, and IT planning.