Have any questions? info@mediranos.com

Payers

Improve Health and Manage Risk


 

Medglob DxCloud is an end-to-end solution to solve data connectivity, quality, and analytics needs. Medglob transforms lab data into actionable insights that allow payers to intelligently manage data and stores it within our AI analytic cloud. Flexible API’s and web services deliver lab results on-demand to payers, all within a HIPAA compliant infrastructure.

 

DxCloud supports enterprise use cases, such as risk sharing, care management, quality programs, risk management, data warehousing, and third party partner access.

Risk Alerts

Finding health risk in your member populations

Payers are challenged to identify health conditions in their members especially newly enrolled. Claims are an incomplete source of clinical conditions and payers need new timely clinical data sources. Medglob offers historic and ongoing near real-time clinical insights to optimize risk adjustment and better manage members. Medglob utilizes over 900 algorithms to interpret and identify conditions even for newly enrolled members. Risk Alerts runs on our industry leading platform DxCloud to flexibly deliver these insights.

Care Alerts

Identifying and tracking health conditions and disease in your member population

Payers are responsible for measuring and improving clinical quality of it’s members. Managing clinical quality requires timely and  clinically specific insights to inform member and provider outreach. Most payers rely on claims but it lacks timeliness and clinical insights. Medglob Care Alerts offers a historic and ongoing disease profile along with disease trajectory to clinically inform quality programs. Early detection of disease can improve HEDIS and Star scores significantly while facilitating better care and reducing medical costs.

Care Gaps

Finding health risk in your member populations

Payers strive to improve quality outcomes and member health. Payers require key documentation to close high-value HEDIS / STARS gaps, however, this documentation is often missing or inaccessible and not available in time to meet HEDIS reporting cutoff timelines.

The Medglob Care Gaps product is specifically designed to accelerate the improvement of a Payer’s HEDIS scores through the streamlined generation of supplemental data qualifier feeds. The product targets & locates hard to find member Lab Test Results and Test Dates to fulfill HEDIS Care Gap reporting requirements well in advance of HEDIS deadlines.