Manage Quality with Payspan

Achieving and maintaining higher Medicare Star ratings can be time-consuming, expensive, and frustrating. Payspan’s innovative Quality Incentive Communications System offers your providers insights and tools driving risk-based incentive attainment.

[divider line_type=”Full Width Line” custom_height=”30″][fancy-ul icon_type=”font_icon” icon=”icon-ok” color=”Extra-Color-2″]

  • Deliver timely provider updates to equate performance with dollars earned
  • Replace cumbersome metrics exchange with intuitive, value-based remittance
  • Eliminate costs of manual medical records requests and onsite chart chase


[image_with_animation image_url=”” alignment=”” animation=”Fade In”]

Through harnessing Payspan’s leading healthcare payments automation platform, the largest in the nation with 750+ health plans and 1.3 million provider payees, payers can exchange quality-incentive information directly with providers – bypassing the need for providers to adopt multiple communications systems and learn new software platforms.
This innovative system directly integrates with a provider’s financial hub, empowering health plans with the ability to deliver actionable incentives through enhanced quality remits and quality notices with care gap alerts. Providers also have the tools to upload and exchange medical records for closing these care gaps.
By streamlining and automating this process electronically with Payspan’s QICS, health plans can accelerate the adoption of, and solidify the adherence to, quality based contracts – all for significantly reduced costs.

[image_with_animation image_url=”” alignment=”” animation=”None” img_link_large=”yes”]

Payspan’s Quality Incentive Communication System

[image_with_animation image_url=”” alignment=”” animation=”Fade In” img_link_large=”yes” el_class=”image”]

Actionable Incentives

The lack of provider adoption of value-based care contracts is often linked to cumbersome and hard to understand quality contracts and metrics exchanges that do not clearly deliver insights into incentive progress.
Payspan’s Actionable Incentives, or Enhanced Quality Remits, address the problem of provider engagement by delivering summarized and visually compelling insights into their value-based contracts with payers. These insights reflect how providers can earn incentives throughout the year performing specific clinical activities.

Quality Notices

Quality Notices give payers the ability to deliver open member care gaps to providers, as well as the potential incentive available for closing those care gaps. This information is presented within their existing payments automation platform, meaning both providers and the back-office can discover new and additional care gaps to close for enhanced provider revenue opportunity.

When a provider is alerted to an open care gap they have closed, but have not submitted proper documentation for, they can upload the necessary attachments via the Medical Records Exchange.

[image_with_animation image_url=”” alignment=”” animation=”Fade In” img_link_large=”yes” el_class=”image”]
[image_with_animation image_url=”” alignment=”” animation=”Fade In” img_link_large=”yes” el_class=”image”]

Medical Records and Attachments Exchange

The Medical Records Exchange enables providers to seamlessly upload the attachments needed to close care gaps, reducing the costly process of manual collecting supporting claims documentation and processing for both payers and providers.
Additionally, this bi-directional tool enables payers to deliver messages to their entire provider network within the payments platform.

Learn How Payspan QICS Can Help You


Let our quality experts analyze your current quality-based care management processes and discuss how our Quality Incentive Communications System can help you achieve and maintain CMS Stars ratings, manage your quality-based contracts, and reduce administrative costs.

Learn more about how we can help you achieve and maintain high cms star ratings