Chart Retrieval Solutions
Moxe’s chart retrieval and release of information solutions transition health systems from manual chart collection, document faxing, and health plan portal activities to automated, auditable, completely electronic record release. Chart retrieval solutions support health plan audit and regulatory requirements and enhance data analysis while maintaining a very small IT footprint. In addition, Moxe’s chart retrieval solutions target only the appropriate patients, acquiring complete charts (including data from notes) from EHRs in a HIPAA-compliant, agile, and transparent process. Current chart retrieval solutions include risk adjustment, HEDIS and Star quality programs, and claims denial management.
Through an automated chart retrieval, Moxe’s solution for risk adjustment provides health plans with only the electronic charts to which they should have access. The electronic charts are requested directly from your health system’s EHR without human intervention. During the process, all release restrictions and confidentiality indicators within your EHR are respected.
Automated chart retrieval for risk adjustment increases both the quantity and the quality of patient charts delivered to health plans, resulting in more accurate risk-adjusted premiums and increased payments under your value-based arrangements. This automated, behind-the-scenes process reduces financial and resource burdens by reducing the time needed to pull charts manually.
You can accurately audit any release of information to understand where and why the release occurred. Moxe works with your health system to provide a custom rules-based approach to determine the release conditions.
Claims Denial Management
One in five claims is delayed or denied. Many denials arise because supplemental clinical data is required from the health plan before remitting a claim. Moxe’s claims denial management solution identifies claims that have been denied for missing clinical information or required medical necessity.
When claims are denied for those reasons, relevant supplemental data is obtained from your EHR system and automatically sent to the health plan – speeding up payments to your health system.
Moxe’s chart retrieval solutions are delivered through Substrate. Substrate is an electronic clinical integration platform, facilitating the real-time exchange of clinical, analytic, and administrative data.
With minimal hours of implementation effort needed from your IT and administrative staffs, Moxe’s implementation methodology reduces the burden typically placed on your teams during integration projects.