Achieving and maintaining higher CMS Medicare Star Ratings is time-consuming, expensive, and can be frustrating. Payspan’s Quality Incentive Communications System(QICS) offers quality program automation through advanced clinical administration tools.

Through QICS’ market leading provider awareness tools, providers are given actionable insights to drive improved clinical outcomes for patients and increased incentive revenue.

  • 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

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 value-based care communications 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.

Payspan’s Quality Incentive Communication System

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.

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.

On-Demand

Payspan is able to leverage your existing data and transform it on-demand into actionable insights for providers to deliver enhanced patient care. Because the data is available directly to the provider and it’s always the most current data, this creates improved provider engagement and patient care. The data can be delivered through Payspan’s online portal or white-labeled solution integrated into provider management systems or payer portal.

Attachments

The Medical Records Exchange enables providers to seamlessly upload the attachments needed to close care gaps in real-time. Reducing the costly process of manual collecting supporting claims documentation. This reduces processing time and expense for both payers and providers while providing auditable medical records. Additionally, this bi-directional tool enables payers to deliver messages to their entire provider network within our payments platform. Providers also have the ability to directly upload documents to payers to support care gap closure.

Learn How Payspan QICS Can Help You

 

Learn more about Payspan’s partnership with one of America’s largest payers with more than 3.9 million members and how they have seen improved provider engagement, CMS Star Ratings all while reducing administrative costs and with Payspan’s Quality Incentive Communications System(QICS) application.

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