WHO WE ARE.

HealthBASE Networks is dedicated to applying transformative, technology-driven solutions towards simplifying and improving the way managed care and medical provider services and information are delivered to all stakeholders, especially in underserved insurance, healthcare and consumer markets.

The HealthBASE leadership includes innovators in the diagnostic, radiology, clinical lab, managed care, patient benefits, billing, web services, HIT, specialty & ancillary medical provider networks, and cost containment sectors with solutions that today serve the insurance, employer, TPA and MCO markets.

Our organization has decades of experience successfully developing, introducing, implementing, managing, promoting and supporting new, innovative and often evolutionary technologies and services in the full life cycle of operational workflows and healthcare and administrative markets that our solutions address.

The HealthBASE Networks executive team is comprised of seasoned, performance-driven change agents and operators with the relevant expertise that is key to engineering and delivering ProviderBASE’s high performance Medical Provider Network + Ordering Platform services and Solution Set.

Our comprehensive and specialized market expertise spans provider, payer and other stakeholder markets in Workers’ Compensation, Property & Casualty Insurance (P&C), Health Plans, Managed Care (MCOs), Employer Self-Insurance, Third Party Administration (TPA/ASO), Union Benefits, Medical Provider Organizations, and Consumer-driven Healthcare.

Our experience includes:

Medical Services | Clinical
  • Specialty and ancillary care
  • High tech equipment and medical device
  • Pharmaceutical and biotech
  • Outpatient facilities and mobile shared services
  • Diagnostic imaging, radiology and clinical laboratory
  • Physician and clinic practices, hospitals and IDNs
  • Managed care, utilization management/ medical review (UM/UR)
  • Provider and clinic management and administration
HIT | Software | Platforms
  • HIT, clinical applications, EMR/EHR, practice management, RIS/LIS
  • Administrative and business software, Platform technologies, Saas/PaaS
  • Software engineering/IT, internet application and database development
  • Web applications and web services
  • Legacy/enterprise systems, web-enablement, interfacing, integration
  • e-Ordering and care coordination systems
  • Clinical Decision Support (CDS)
  • Provider networks/PPO management applications
  • Call center and Patient concierge systems
  • Referral management applications
  • Eligibility and benefits determination
  • Reporting & Analytics

We look forward to showing you how HealthBASE Networks and ProviderBASE® can help you quickly realize the next levels of performance, service, value and returns for your organization and customers.

WHAT IS CLINICAL DECISION SUPPORT (CDS)?

“Clinical decision support systems link health observations with health knowledge to influence health choices by clinicians for improved health care.” (Robert Hayward, Centre for Health Evidence)

HOW DO YOU AUTOMATE THE PRIOR-AUTHORIZATION PROCESS?

With evidence-based and industry guidelines, payer rules and patient benefit details made available at the time- and point-of-ordering, a system-driven approach can be implemented that very quickly helps determine, validate and authorize orders that meet defined ‘appropriateness’ criteria — delivering new levels of automation, performance, throughput, savings and returns.

HOW DO YOU IMPROVE REFERRAL MANAGEMENT?

Ordering and Authorization routing systems that integrate with Provider organizations, Networks, cost containment vendors, and service platforms are able to seamlessly select, coordinate, route and exchange referrals and scripts with optimal locations, specialists and suppliers using advanced tools and approaches for capture, filtering and direction — improving efficiencies, performance and results for all stakeholders.

Healthcare | Managed Care
  • Managed care, utilization management/ medical review (UM/UR)
  • Clinical guidelines
  • Prior authorization
  • Provider networks/PPOs and cost containment systems
  • Health plans and insurance systems
  • P&C/workers compensation/auto
  • Employer self-insurance and union funds
  • Employee benefit programs and eligibility determination
  • Business process outsourcing, call centers, patient concierge
  • Healthcare and insurance transactions and EDI
  • Claims processing and adjudication
Operational | Financial | Strategic
  • Market introduction and service/product commercialization
  • Clinical operations
  • IT management
  • Board direction, consulting & executive leadership
  • Strategic operations and marketing
  • A/R performance and portfolio management
  • Investment and M&A

Medical Cost Containment
IS IN OUR DNA.

GET STARTED