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The pandemic is difficult for individuals' mental health. HMS' Eliza helps identify how people feel and delivers messages to the right person at the right time as part of a personalized intervention.
HMS' Clinical Claim Reviews leverage a vast knowledge base from clinical experts, credentialed physicians, and healthcare data scientists to improve payment accuracy and minimize pay-and-chase.
HMS' Medicare Advantage Premium Protection uses member insurance information from CMS to determine whether Medicare has primary or secondary responsibility for paying claims.
Health plans need to consider the impact of the TCPA when communicating important health information. Non-compliance can have serious financial implications. HMS' Eliza helps to ensure TPCA compliance
Episode of Care is a semi-automated payment accuracy solution from HMS that analyzes a patient's claims history related to an episode of care to identify discrepancies and recover overpayments.
Plans need accurate, real-time other primary payer detection and verification to avoid unnecessary cost HMS' COB solution leads the industry with the most efficient matching technology available.
HMS' approach to population health management focuses on the whole person, leveraging data, analytics, and behavioral science to inform effective mutli-modal engagement strategies.
HMS' Elli provides reliable intelligence into your member population by generating actionable predictive models that help health plans prevent unnecessary spend in the Emergency Department.
Here are the most frequently asked questions about HMS' Subrogation services.
HMS' Eliza provides dynamic, multichannel outreach for all kinds of rapid messaging needs, including COVID-10, that can launch in as little as 24 hours.
Personalized patient outreach backed by behavioral science empowers patients to take action on their health. This results in better outcomes and improved quality, while avoiding the unnecessary costs.
HMS' suite of Medicare Advantage services are designed to help MA plans overcome industry forces that create pressure to optimize revenue, reduce costs, minimize risks, and improve outcomes.
Pharmacy Disallowance allows HMS clients to achieve higher recovery rates on high-cost medications by leveraging the patient history, pharmacy/physician relationships, and pharmacy provider expertise.
Inpatient hospital readmissions are costly for all payers. HMS can target readmission pairs in which the claims data indicates the second admission is for the same or similar condition.
HMS' Subrogation Services identify potential recovery for healthcare claims paid for injuries to conduct both casualty recovery and mass tort subrogation.
Incorrect payment of genetic test claims persists despite preauthorization programs. HMS offers a solution that generates significant savings by increasing payment accuracy for genetic testing.
