15 Mar 2018

Healthspace Provider: On Demand Eligibility and Claims Information for Physician Office Staff

Healthspace Provider: On Demand Eligibility and Claims Information for Physician Office Staff

At HCIactive, one of our primary goals is to use technology to make health care administration easier. That’s why we offer providers and physician office staff an effortless way to search for patient information such as claims and eligibility status, benefits coverage information, and ID cards.

To start, Healthspace Provider does not require a username or password to log in. Instead, patient privacy and confidentiality is protected using “exact match” searching. This means that physician office staff must enter all required information correctly to retrieve data. By eliminating this login step, physician office staff doesn’t need to keep track of one more login credential or add an extra step to their already busy day. Information can be accessed quickly and securely.

HCIactive provides a secure, phone-based tool for patient information inquiries as well. Interactive Voice Response (IVR) technology provides a convenient alternative to the online portal. Physician office staff would simply call the designated IVR phone number and input required information at each prompt.

Eligibility Inquiries

Physician office staff may search by eligibility or claims information. To identify a patient’s eligibility, the user must simply enter the required information and the patient and subscriber’s data is immediately displayed. From a single screen, you can view both the member and subscriber’s basic data, member eligibility status (including whether or not their benefits are current), and plan documentation. The documentation is available as downloadable pdf files. This is a streamlined screen to provide the most commonly reviewed data in one place, but if more specific information is required, the Claims Inquiry search provides more detailed records.

Claims Inquiries

The claims inquiry tab is used to access detailed records on a claim made on a specific date by a particular patient. The full explanation of benefits can be easily downloaded as well.

By making it easy to reference basic patient information, accessing claims and assisting patients can be a painless process. As with all our resources, it’s our mission to make technology work for you. Because Healthspace Provider is easy to access and delivers the most patient information on one screen, HCIactive can save valuable time and resources for your physician office staff.

07 Feb 2018

HCIactive and WiserTogether partner to deliver advanced health care technology solutions to employers

HCIactive and WiserTogether partner to deliver advanced health care technology solutions to employers

WiserTogether Return to Health extends the HCIactive technology platform further enabling employee engagement and improved outcomes

Glenwood, MD (Feb. 7, 2018) — WiserTogether and HCIactive have entered into a partnership to deliver the WiserTogether Return to Health solution as an integrated part of HCIactive’s Workplace Wellbeing product suite. HCIactive leverages cloud-based technology to deliver health care management tools. Including Return to Health in the HCIactive product suite will enable organizations to offer employees a powerful tool to manage their own health care.

WiserTogether Return to Health is a web and mobile solution, which guides people to the most appropriate, effective and often less intrusive treatment options for that individual. Return to Health enables employees to make thoughtful and informed decisions about their health care by providing easy to understand information and guidance, resulting in lower clinical costs, higher compliance with best practices and faster recovery times.

HCIactive is a health care technology firm that focuses on delivering innovative solutions to employers that improve the lives of their employees. Through their Workplace Wellbeing suite of products, HCIactive offers resources needed to develop a culture of health. Return to Health extends this suite and provides a tool for easy engagement and ongoing treatment planning.

Henry Cha, CEO of HCIactive commented: “WiserTogether’s clinically proven treatment guidance solution provides our clients a critical health care management tool to enhance experiences, better manage per-capita costs, and improve outcomes while enabling each participant to be a true partner in the care process.”

Max Kahn, CEO of WiserTogether shared his perspective: “HCIactive delivers an impressive suite of cloud-based employer solutions. The addition of Return to Health to their offerings extends their already powerful offerings and further engages employees in the management of their health care. We are excited about our new partnership with this technology leader and the value we can deliver to the market.”

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About HCIactive

HCIactive, Inc. provides advanced health planning solutions to employers that help attract and retain the best employees by engaging them in their well-being and workplace. Our integrated technology platform, Healthspace™, runs results-driven population health and incentive management programs designed to mitigate risk, control health care costs, support Affordable Care Act compliance, and improve member outcomes.

About WiserTogether

WiserTogether is a leader in consumer-focused health care information technology solutions that advance clinical outcomes, financial and patient satisfaction results. Our innovative solutions enable consumers to circumvent the immense amount of data on the internet and in the market and effectively guide individuals to the best treatment options for them. To learn more visit www.wisertogether.com.

23 Dec 2017

A Culture of Health Reaches Far Beyond the Doctor’s Office

A Culture of Health Reaches Far Beyond the Doctor’s Office

By Henry Cha, Chief Executive Officer, HCIactive

It used to be, you went to see your family doctor for everything. The stereotype is of a kindly physician who handled checkups, shots, and illnesses for the whole family, often for many years. Maybe they even made house calls. These days, though, medicine has become a lot more compartmentalized. You may see one doctor for preventive care, another for cardiology, and still more for allergies, dermatology, etc. Medicine has made incredible strides in the past 50 years, but it’s also lost that individual, personal touch that the stereotypical family doctor was so good at.

One of the lessons I’ve learned in my time as CEO of HCIactive and founder of Habeo Health Plan is that no matter how great new technology and initiatives are, they only work if members engage with them. That’s why fostering a culture of health—whether through a PCMH, a workplace wellness program, or preferably some combination of both—is vital to improving outcomes and lowering costs.

By fostering [a] culture of health at work and providing tools like PCMHs and online member portals to manage patient care, employers create a flow-on effect from members to their dependents.

For example, let’s take a sample employee. Say he’s 45 years old, overweight, and a smoker. He’s likely at risk for a number of health conditions and potentially seeing multiple doctors (who may or may not be communicating with each other). But let’s also say the company he works for has committed to fostering a culture of health. They’ve implemented a workplace wellness program with incentives, resources (including a smoking cessation program), and a self-service online portal to make self-care easier and less confusing. As part of his employer-sponsored health plan, our employee is now able to see doctors at a PCMH. Although he still may be seeing several specialists as well as a preventive care practitioner, they’re now all part of one organization, working together to treat the patient holistically.

Our sample employee is certainly receiving better care under this new model, but his actual medical care is only a small part of a true culture of health. Health isn’t just associated with the doctor’s office anymore; it’s where we work, live and play. By living and working within a culture of health starting at the company level, he is learning new habits and being rewarded for healthy behaviors, like quitting smoking or losing weight. His self-care is likely improving his productivity and lowering his healthcare costs—not to mention the effect it’s having on other members of his household. Studies have shown that behaviors (healthy or otherwise) are often shared among people who live together. If the employee is learning to eat better and exercise more, he’s likely passing on those commitments and better results to his family who, as members of his health plan, also affect healthcare costs. By fostering that culture of health at work and providing tools like PCMHs and online member portals to manage patient care, employers create a flow-on effect from members to their dependents.

Health isn’t just associated with the doctor’s office anymore; it’s where we work, live and play.

It can be scary and confusing for patients and their families to deal with doctors, hospitals, and health insurance. But the education and point of care offered by a strong culture of health can alleviate a lot of those stresses. By helping patients take a more active role in their own care, plan providers and employers can improve outcomes not just for employees, but for families and their communities. It’s the 21st century equivalent of the old family doctor.

13 Oct 2017

Employee Wellness Programs Increase Efficiency and Enhance Corporate Culture

Employee Wellness Programs Increase Efficiency and Enhance Corporate Culture

By Erica Solomon, Human Resources Director, HCIactive

As a wellness company, we know that we must practice what we preach. In our case, that means running a successful employee wellness program, from both a financial and company culture standpoint. As HCIactive’s Director of Human Resources, it’s my responsibility to manage our own wellness program. Of course, I have an advantage: my co-workers work on wellness initiatives every day, so they understand the value of the programs we offer. I don’t have to prove to my employees that wellness programs work, but I do have to make sure our program is interesting, challenging, and beneficial to both the individual employee and the company.

From a financial perspective, the best value of a wellness program is not so much in dollars saved, but in increased efficiency. Because my employees are healthier and more proactive about healthy diet and exercise, I have significantly fewer unplanned absences, on average. My employees take fewer sick days, which means less scrambling to cover for absent co-workers and increased productivity across the workforce. We’re also seeing a decrease in prescriptions for chronic conditions and a decrease in doctors’ visits. It’s important to note the reason for those decreased doctors’ visits, by the way. Not only are members getting sick less, but they’re taking control of their health. They are more knowledgeable and communicative with their medical professionals, leading to more efficient and effective visits. By taking an interest and an active role in their own healthcare, my employees are getting healthier and saving the company money.

The best value of a wellness program is not so much in dollars saved, but in increased efficiency.

Our wellness program is also a vital part of our company culture. While I wouldn’t say that the program alone attracts and retains top talent, it does play into the larger atmosphere of our office. It sets the tone for the type of company and employees we want to foster—and there’s good data to prove that programs like wellness initiatives and relaxed company dress codes create more efficient and engaged employees. Workers who take part in the wellness program and company challenges are showing boosted productivity and energy levels. We offer step challenges, nutrition incentives, and so on through our member portal, and we spice it up (pun intended) with events like a chili cook-off and a soccer team. The goal should be to leverage your wellness program to enhance company culture. While these particular events might not work for every company, maybe there’s an interest in a lunchtime walking group or a healthy cooking class instead. Again, the wellness program is only part of the larger corporate whole, but it helps us create the kind of environment where people want to contribute and feel part of a team.

 

I love my job

Implementing such a program seems daunting, but there are some strategies that will help overcome most obstacles. These days, nearly three-quarters of employers offer company-sponsored wellness programs, and even more—about 87%—are committed to improving workplace wellness [1]. There’s a wide disparity in the effectiveness of these programs, however, which leads newcomers to question the value of putting such a plan in place. With the right program and the right mindset, however, the Human Resources (HR) department can increase effectiveness and decrease the time requirement.

One of the biggest obstacles that the HR department faces in implementing an effective wellness program is, of course, the time that it takes to administer it. I’ll agree that a good program does take time and effort to manage. But I think about it this way: if I spend the equivalent of 3 days a month implementing this program, but save 24 hours of unplanned paid time off throughout the company, that’s a win from a productivity standpoint. Saving more than 24 per month of unplanned PTO, which we do, is a win for both efficiency and finance. Absenteeism is costly to a company, so by decreasing the amount of sick days my employees need and increasing the number of deadlines met (a productivity measure), my time investment pays huge dividends.

If a member can access their benefits information and incentives in the same place, it drastically cuts down the amount of time HR has to spend administering the program.

The HR department can—and should—use technology to save time and effort on wellness programs. If you ask me, self-service is the way to go. Offer a member portal so employees and their dependents can manage their own healthcare data and access challenges and resources. If a member can access their benefits information and incentives in the same place, it drastically cuts down the amount of time HR has to spend administering the program. Through our member portal, our employees can take greater control over their own health by knowing their numbers, learning more about preventable conditions, and communicating with health coaches to reach their wellness goals. Best of all, they are able to choose and manage their own benefits selections which previously would have required the assistance of HR staff.

There are significant investments in starting a wellness program, both monetarily and in terms of time commitment. These costs can be combatted by implementing an established self-service program. By using a healthcare technology company that specializes in supporting wellness programs, HR directors have the option to fully customize a program to their specifications, or to let the outsourced company handle programming, incentives, and so on through a pre-set menu. All your members have to do is access it, saving HR the time and trouble of creating a workable program. The larger savings, however, is in the way your employees will react to the program. Lower rates of absenteeism and higher productivity, not to mention health plan savings, leads to a healthier, more engaged work force and a more efficient company.

04 Nov 2016

Top 5 ACA Reporting Challenges to Avoid This Season

Top 5 ACA Reporting Challenges to Avoid This Season

By John H. Capobianco, President and CMO of HCIactive

The July 31st deadline for ACA reporting passed this year with an audible sigh of relief. For most companies, complying with the IRS reporting requirements was more difficult than expected, and they wound up outsourcing the process to payroll, benefits administration, or ACA reporting vendors. As one of those ACA reporting vendors responding to the call of duty, we at HCIactive witnessed and successfully addressed the challenges these companies faced. The good news is that these challenges were categorically similar and easily preventable.

 

Below are the top five ACA reporting challenges that companies experienced last season.

1: CALCULATING FTEs WAS COMPLICATED

Companies have long recognized that what the IRS defines as a full-time equivalent differs from what companies typically consider a full-time employee. Companies understood that they had to offer health insurance to workers who might not have qualified under in-house definitions, but when it came to documenting who those people were, and whether they received coverage, things got complicated. There were more employees who fell outside of standard definitions than expected, and it was not that straightforward to confirm who they were. The government offered more than one way to determine if someone is “full-time”, but neither method reflected how workers and their hours are represented within common payroll and benefits systems. This complexity created a lot of manual analysis and second-guessing.

2: TRACKING WAS TRICKY

In-house systems don’t “speak” ACA—they are not set up to keep track of everything your company needs to know to efficiently comply with the law. The difficulty of knowing who qualifies as full-time is just one of the tracking failures uncovered during the reporting process. Other tracking issues have to do with who was offered coverage, who accepted, and who rejected, who has taken a sabbatical or a leave of absence, or is out on disability. Some salaried employees sometimes produced ACA anomalies, as did seasonal employees or contractors whose hours flex up and down. This latter group may qualify based on a high-work period, but then have their average hours drop and not rise again within the timeframe necessary to maintain eligibility. Depending on how a company is tracking and when it runs the report, it may be out of compliance and not even know it.

3: COMPLETING THE FORMS WAS CHALLENGING

The IRS forms 1094 and 1095-C were not easy to complete. The information entered on those forms needed to be recorded as specific codes. The codes reflected an employee’s status, their eligibility for certain plans, whether the employee enrolled and whether they qualified for an affordability safe harbor, among other details. Companies were challenged by the effort of choosing the right code. Technology might have helped, however their systems weren’t ACA compatible and many still aren’t.

Few if any companies have HR, payroll, benefits administration, or other in-house systems capable of reporting employee-related information in terms that can be easily queried and converted into those codes. More commonly these systems report data in native formats that differ even from each other. It’s no wonder that filling out the forms ended up being much more difficult than companies thought.

4: ENCOUNTERING LOTS OF ERRORS

Finally, you document everything you need, code it accordingly, and transmit the whole package to the IRS, only to see that dreaded message: ERROR. Even companies with the best of intentions and the most ACA-friendly systems still encountered errors in transmitting their forms. The IRS’ electronic submission platform gets a lot of blame for the error frequency, but there is good reason to suspect that most of the errors are the result of dirty data. Employee record systems sometime contain incorrect information. The wrong birth year for an employee, or an incorrectly transposed social security number, or a misspelled name—any anomalies will flag that ERROR message.

5: CONTRACTING THE WRONG VENDOR

As the deadline approached, employers realized they were in over their heads and turned to trusted service providers to help. It was logical to think that benefits administrators, payroll companies, and other third parties would know how to help, and many jumped on the business opportunity. Unfortunately, the lack of experience that employers had with the reporting requirements extended to third parties as well. This was the first time for everyone. The same challenges around tracking, translating data into the right codes for the forms, and data access applied as much, if not more, to third parties as to the employer itself.

LOOKING FORWARD

The challenges companies faced for 2016 share a common theme—they all stemmed from a lack of knowledge and technology needed to define, track, record, and report information about their employees.

Experiences from the past should make companies better equipped to address the challenges ahead. Most companies know by now that the process is not one that is best handled manually or in-house, but rather outsourced to experienced ACA reporting vendors. A trustworthy vendor should provide expertise, along with the integrated technology needed to execute and provide a system of record for tracking, reporting and filing the required information and forms. Additionally, with the last season behind us, the vendor should have a proven track record for achieving a high IRS acceptance rate for its current clients proving that their technology actually works.

To learn more about the tips and technology needed to overcome ACA reporting challenges, download this free webinar or contact us!

HCIactive relieves administrative burden and takes the guesswork out of ACA reporting and compliance with a robust integrated technology solution.