https://store-images.s-microsoft.com/image/apps.44402.a8acb245-c78f-4928-918c-99889f545633.b017b297-d29b-433c-a8cd-bf05daca0606.2393ae9b-6e51-4c57-ac09-09990f52012c
Real Sight
por CitiusTech
Just a moment, logging you in...
Price Transparency
CitiusTech’s Price Transparency Solution - RealSight™ - ingests and curates publicly available Machine Readable Files (MRFs) to provide and end-to-end Data & Analytics Solution for Price Transparency to deliver Payer, Provider & Member Insights.
Solution Focus: The “Transparency in Coverage” Rule, that went live on July 1, 2022, required health insurers, group health plans, including self-funded clients, to provide cost-sharing data to consumers via Machine-readable files (MRF). These Machine-readable files provide pricing data for covered items and services based on in-network negotiated payment rates and historical out-of-network allowed amounts.
CitiusTech has been among the pioneers, having spent close to two years working on machine readable files through building and implementing our regulatory compliance solution - MRFE (Machine Readable File Engine) for health plans. It is this foundation that’s been instrumental in designing and developing our Price Transparency Analytics solution - RealSight™.
Key Business Use Cases:
- Optimization and Rate negotiation for network provider
- Enable narrow networks & merit-based steerage
- Improved Benefit design for insurance products
RealSight key components:
- Enriched Data as a Service: Scalable data platform to ingest and store publicly available MRFs & prepare for analytics
- Bring Your Own Data: Isolated cloud platform combining MRF data with enterprise datasets, Operational analytics
- Benchmark Reports: BI dashboard & custom reporting: top provider rate benchmarking, service rate comparison
- Packaged Analytics Library: Purpose-built dashboards – e.g., network mgmt./ contract negotiation, benefit design
- Analytics as a Service: Integrated analytics to existing systems for decision making; Conversation AI solution
- Data Quality Scorecard: Scorecard for ingestion of payer MRFs; data quality and profiling measures; monthly trend
RealSight advantages:
- Scalable SaaS-based data platform to ingest & store large volume of pricing information from National, Blues and other payers
- Monthly curated data from multiple payers in readily consumable format for analytics use cases across payer value chain
- Comprehensive data quality checks and standardization to address data inconsistencies, along with clinical equivalence to analyze & extract a larger picture
- Flexible architecture to include additional payer domain datasets (claims, quality, membership etc.) for future use cases beyond MRF
- Pre-built dashboards for specific payer workflows (network management) that can be further customized per client requirements
- Reduced operational cost for payers to host and manage humungous datasets
Visão geral
https://store-images.s-microsoft.com/image/apps.64995.a8acb245-c78f-4928-918c-99889f545633.b017b297-d29b-433c-a8cd-bf05daca0606.13851fd0-be29-4a77-bf5e-4ebf1c6ae9ed
Outros aplicativos de CitiusTech
MRF Engine Accelerate CMS Compliance Coverage TransparencyCitiusTechAccelerate CMS compliance and improve member experience with coverage price transparency
+1
Applicable to:
SaaS
NaN out of 5
Price Transparency for Provider SystemsCitiusTechAnalytical solution for higher rate negotiation, identify pricing irregularities and price benchmark
+1
Applicable to:
SaaS
NaN out of 5
CitiusTech GenAI Medical AllyCitiusTechGenAI Medical Ally solution can help reduce provider burnout and improve patient experience.
+1
Applicable to:
SaaS
NaN out of 5
CitiusTech GenAI Payer Agent AssistCitiusTechThis solution helps call center team members provide accurate explanation about a members queries
+1
Applicable to:
SaaS
NaN out of 5
Cross Geography Pharmaceutical Data Privacy FrameworkCitiusTechEnsures policy-compliant access to Pharmaceutical data across various regions
+1
Applicable to:
SaaS
NaN out of 5