WHAT WE DO.
The HealthBASE Networks Platform — ProviderBASE® — is a transformative, technology-driven solution set that helps to better coordinate patient care, reduce administrative roles, and manage costs by ensuring that the right order is performed timely, at the right place, by the right people, and at the right price.
ProviderBASE elevates Utilization Review and Medical Provider Network performance and managed care program savings by addressing ordering ‘appropriateness’, accuracy and stakeholder exchange — at the critical time and point-of-order.
ProviderBASE delivers highly automated capture, filter and direction of evaluated patient service orders and authorized referrals using intelligent, rules-based e-Ordering with integrated clinical decision support (CDS), expert, evidence-based guidelines, and on-time transactions between physicians, administrators, vendors, facilities, specialists and suppliers.
On-demand Clinical Guidelines – for quick, easy and accurate reference
Diagnosis-driven Decision Support – via clinical guidelines and payer, client and industry rule sets
Real-time Reporting – order ‘appropriateness’ scoring, order status, notices, analytics
Medical & Utilization Review ‘Triage’ – order capture with built-in inital (+) filtering and direction
Automated Authorization – per payer rules; link review agents; coding and routing to stakeholders
Optimized Provider Selection & Referrals – via Network PPO and/or direct to provider
Online Patient Concierge – for scheduling, instruction, reminders, confirmation, and more
Interface Clinical & Business Data – EMR/EHR, UR/UM, bill review, PMS, billing, claims, QA and more
ProviderBASE® is a tightly integrated, next-generation Medical Provider Network and Ordering Platform driven by Clinical Decision Support (CDS).
ProviderBASE makes it fast and easy to realize new levels of savings and returns with smart, streamlined and rules-based approaches to Medical Ordering, Utilization Review, Prior Authorization, In-Network Provider Selection, Referral Routing, Care Coordination, Bill Adjudication, Reporting and more.
ProviderBASE® Helps Doctors, nurses and care managers instantly evaluate, choose and order clinically ‘appropriate’ tests, procedures, supplies and services in optimal compliance with industry and medical guidelines, payer rules and patient insurance benefits.
ProviderBASE® Helps Claims adjusters, case administrators, care managers and review nurses intake and process order requests and pre-authorizations, and then coordinate approved referrals and patient services with designated managed care systems and ‘in network’ providers.
ProviderBASE® Helps Networks of ancillary medical providers, testing centers, labs, clinics, treatment facilities, suppliers and other services in capturing, receiving, filtering, managing and directing approved referrals to optimal locations and specialists.
How e-Ordering with CDS elevates both Utilization Review and Provider Network performance
In the managed care and medical cost containment worlds, the time and point-of-order are usually the starting point of everything -- the 'source of the flow' as it were. The opportunity to -- at the origination stage -- capture, filter (for 'appropriateness'), authorize and direct orders and referrals to optimal service providers is paramount in managing other 'downstream' patient care, medical expense and insurance benefits. With cloud-based ordering, decision support and provider network tools, point- and time-of-order medical and referral management can now be fully realized.