Serif Health’s Post

As Change Healthcare reviews data impacted by their recent cyberattack, what does the notification process look like for both large and small practices? For an individual patient alone there could multiple providers that they visit who are connected to Change's systems, which means their data could have been compromised more than once. Frankly, the notification burden resulting from this cyberattack is ginormous, and it helps put into perspective how much fallout there can be from a major breach, even from a relatively minor one. How are you set up to handle such a task?

Having the freedom to choose is an innate human need.  Policyholders’ call for greater integrated shield plan portability aims to address that need. This discussion paper by Singapore Actuarial Society’s Health Committee explores how portability may be introduced under different perspectives of fairness that may exist in our population. Ultimately, behaviour of any policyholder in an integrated shield plan will affect the experience of everyone else in the plan. I believe that, through dialogue involving members of the public from diverse backgrounds, Singapore can build consensus in the community about what kind of portability rules best fit the Singapore context.

Frustrated to no end that the companies I do business with don't even take the simplest steps to provide accurate, timely data. Here, all payments were made via credit card on file, still it shows payment made with a "paper check". Huh? I have had enough with Anthem, Inc. I signed up for a health plan with Anthem thru CO Health Marketplace. For the last several months, I have been getting almost daily USPS mail from Anthem with conflicting and completely inaccurate information eg my account is past due, that I owe $xxx by March'24, then another $yyy due in June'24 - all this in Sept and Oct 2024! I get so many of these postal mail that I don't even bother to pay attention to them. Ever heard of Alert Fatigue? This is an example of that. I have also spent many many hours on the phone with their support team - the only way to talk to a live person (I'd be fine w email/chat but thats a completely useless support channel with Anthem) - documenting each and every interaction and promise of follow up. They never follow up. Decube exists entirely to build trust in the data for your consumers. Pls reach out, if someone is actually reading this and cares about building trust with your customers and their data. Anthem, Inc. let us help you. #datatrust

What's a key priority for a successful revenue cycle? It all starts with good data at the beginning of each patient visit! Ensuring accurate and complete information - like insurance verification and demographic details - sets the stage for everything that follows. When we prioritize accurate data collection upfront, we: Reduce claim denials Accelerate reimbursement Improve the patient experience Inaccurate or incomplete data can lead to costly errors, and payment delays, ultimately affecting a practice’s financial health. By getting it right at the start, we can ensure smoother workflows and better outcomes for providers and patients. #RevenueCycleManagement #DataAccuracy #HealthcareEfficiency

Add our Denials Navigator to mitigate the effect of denials on your revenue cycle. Stop spending hours analyzing data and reviewing hundreds of denials trying to determine root causes; Denials Navigator has dynamic alerts for regular updates! Read here: https://zurl.co/mm8H

Inaccurate data is the leading cause of claim denials which can cause revenue losses of upwards of $500,000 per year for providers. Partnering with an expert in practice management such as Allied Practice Management Solutions www.alliedpmsolutions.com can help providers prevent claim denials and recover missed revenue.

Private insurers are using a diagnostic coding system to increase their profit. Watch this video to learn how. https://trib.al/daFW2cb

The UnitedHealthcare Hack reinforces the urgency for every organization to shift from just curating the cyber stack to managing cyber business risk. Being able to quantify probable frequency and potential loss magnitude of cyber incidents is no longer an option. Using Safe and its Materiality Module, based on FAIR-MAM, organizations can produce defensible output for boards and regulators, especially critical with hacks like UnitedHealthcare. The materiality module can: 1. Proactively calculate and track risk before an incident becomes material. 2. Access Materality during an incident 3. Track materiality post incident Safe provides a unified platform for managing all your third and first party cyber risk. It answers two critical questions, what are my top cyber risks, and what do I do about it? Safe empowers the largest global enterprises, including Facebook, Netflix, ADP, Chevron, GSK, IHG, Molina Healthcare, IHG, and Expedia on their cyber risk journey. #unitedhealthcare #cybersecurity

Verifying the patient's eligibility and insurance coverage is one of the crucial steps in revenue cycle management. This includes contacting the patient and their insurance to confirm their coverage and avoid claim denials. With Revenulytics' 98% clean claims rate, we ensure that our patients won't get unexpected bills. Visit our website at www.revenulytics.com and check our eligibility and verification process! #Revenulytics #RCM #Eligibility #Verification

So let me get this straight… The largest EMR company in the country (Epic) participates in the largest nationwide trust framework (Carequality) which permits “onramp” companies (like Particle Health) that, in turn, provided protected health information API data access, for a fee, to other companies, among them a company (Integritort) which uses the data for the “apparent purpose of identifying potential participants in class action lawsuits.” (quoting Epic’s Issue Notification) What could possibly go wrong? Well, something did go wrong.  Participation in Carequality’s trust network relies on, well, TRUST, and that the queries for patient data are for the intended use of patient treatment.  It appears that both were violated here.  Healthy networks can suffer a failure, self repair, and still continue to operate, and I’m reading that is the case with Carequality. Scott K., you likely tagged me on Matthew Holt's post because of my history running Dossia, a personal health record company, and also what I’m doing now - running a FHIR-based healthcare analytics company. A good friend of mine was running a company that has a groundbreaking breast cancer lab test, and he was raising money right at the height of the Theranos debacle.  It was nearly impossible to raise money in the diagnostics space for a couple of years.  He called it “The Theranos Effect.”  Both the onramp companies, and many of the companies that are clients of the onramp companies are VC backed.  Proceed carefully. At Dossia, a SaaS, we ultimately collected PHI for several million people on our servers.  We spent a lot of money with attorneys, security professionals, and auditors to make sure we were doing everything we could to operate within the regulations, and keep the records safe.  It was a ton of work.  Lots of sleepless nights.  Today, our customers download our software and run it in their environment (or their own cloud account).  Now, I sleep like a baby. Lastly, many people continue to express their frustration that the healthcare IT architecture we have is all wrong - that we should have the patient at the center of the healthcare system, and if we did that, we wouldn’t have these problems.  I would love to see that too - and Dossia was one such attempt at achieving that goal.  I keep telling people - we need to work together with a reality-based frame. It’s true that if we were to re-architect the healthcare system from scratch, it wouldn’t likely be anything like we have today.  It would be totally different, with entirely different problems. $13B was invested into Uber to disrupt the taxi industry.  I think it’s going to take a LOT more than that to disrupt healthcare.  Be patient, we’ll get there.