Medecision launches aerial UM Connector to drive in-network referral sand cms reporting compliance for government health plans and tpas

In a recent press release, Medecision announced it has launched a new SaaS application, Aerial UM Connector, that automates authorizations and referrals in order to drive compliance and reduce costs for health plans and TPAs with substantial Medicare and Medicaid populations.

The new app ensures regulatory compliance and reduces out-of-network referrals by connecting provider contract details with member enrollment details, presenting care managers with real-time, context-relevant information that increases provider and member satisfaction by improving care delivery.

“Many of our clients manage complex populations with tens of millions of lives, so proactively guiding members to in-network providers is critical to controlling costs,” said Deborah Gage, President and CEO at Medecision. “Conservatively, an out-of-network office visit costs $20 more than an in-network visit. If 20 percent of annual office visits are out-of-network and we can convert half of them to in-network, based on average reimbursement and utilization rates, we estimate that our clients can save close to $4 PMPY for just one ICD-10 code. When you also consider the operational and labor cost savings, the ROI quickly reaches 10x.”

Editor's note: this blog post originally appeared on Medecision's website.

To view the full blog post, please click here.

News from our Partners

Editor's note: this blog post originally appeared on Medecision's website.

To view the full blog post, please click here.

Newws from our Partners

Copyright © 2023 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Whitepapers

Featured Webinars