Bobby Samuel

"One of the biggest challenges I see health plans struggling with...is the cost of making disparate systems actually exchange data. It takes work, time, and specialized technical resources to connect all of these systems—and not all payers have the resources available to embrace all that robust interoperability strategies can deliver." Reinvesting in existing technologies is a primary focus for health plan leaders going into 2025. Interoperable solutions are essential for surfacing and sharing up-to-date intelligence and streamlining workflows. Discover how Vice President of Product Development Bobby Sherwood and his team empower HealthEdge® customers to maintain compliance and leverage real-time data sharing capabilities. Read the Q&A on our website: https://ow.ly/zlCi50U2vbn #Interoperability #TechnologyIntegration #HealthPlanStrategy

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When it comes to language models in healthcare, smaller is better. Small Language Models (SLMs) are making more of an impact than their larger counterparts. Our VP of Delivery, Diego Espada, discusses how SLMs outperform larger models like ChatGPT in his latest HIT Consultant Media article. Here's how SLMs are transforming the industry: ➡️ Reducing diagnosis times by quickly analyzing patient data. ➡️ Breaking language barriers with accurate translations. ➡️ Speeding up reimbursements by automating paperwork and correcting errors. ➡️ Streamlining admin tasks to let healthcare professionals focus on patients. ➡️ Keeping specialists updated by summarizing the latest medical research. SLMs tackle critical issues like accuracy, data privacy, and cybersecurity. They're nimble, powerful, and ready to make a direct impact. 👉 Read Diego's full article: https://lnkd.in/d5sHEC86

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"Maximize healthcare capacity with AI and prescriptive analytics." Mohan Giridharadas, Founder + CEO of LeanTaaS, breaks down how the company adds value to health systems and more on #NYSEFloorTalk with Judy Khan Shaw.

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Here are our EVP of Health & Business Development's final thoughts on the Sage Growth Partners survey of more than 100 C-Suite executives about "Health System Leader Perceptions and Priorities." #health #healthcare #digitalhealth #virtualcare #patientcare #telehealth #telemedicine

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💜 Improve patient care 💜 Fast-track digital transformation 💜 Interoperability without disruption 💜 Faster ROI Toca.io's powerful combination of apps, automation and extensible integration in a single low-code platform enable Trusts to tackle interoperability challenges, streamline data flow and reimagine patient pathways. It saves time, minimises errors, and boosts patient satisfaction. 🟣 Clinic Scheduling & Management: Automate scheduling for clinician change management. 🟣 General Clinical Administration: Automatically build and update GP Practices in GPAS (Cerner). 🟣 e-Referrals & Appointments: Automate the download of e-RS referral notes & attachments and upload to EPR. 🟣 Comorbidity: Automate updates to patient records for comorbidities. 🟣 Data Cleansing: Data validation and cleansing of patient records. 🟣 Data Migrations: Moving and updating patient reports from legacy systems to a new Patient Administration System. 🟣 Patient Record Updates: Automate adding diagnostics and alerts for patients. Robotics AI 🟪 Unleashing human minds

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Today's Forbes article describes how siloed provider directory data can ultimately lead to surprise bills and frustration from patients. Greater pricing transparency in healthcare is yet another benefit of breaking down data silos and working towards interoperability. https://hubs.ly/Q02BW6510 #Interoperability #Healthcare #HealthcareIT #DataSilos

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What's your winning strategy for healthcare's claims game? Kathleen Quill Noyes, MHA, CPC, CRCR shares her cautious optimism in exploring #AI for healthcare #revenuecycle. "Everyone's really focused on how quickly they can absorb AI and how quickly they can apply it to their revenue cycle and their processes––and that's exciting. But don't wait until the perfect moment or until that next big thing (to get started)," she says. Watch the video interview: https://lnkd.in/g6pFF3Wd #revenuecyclemanagement #healthcare

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Navigating the complexities of high-cost in-network claims in healthcare requires more than the use of AI. Learn why an approach that combines AI and human clinical expertise enables payers to efficiently manage the volume, complexity, and nuance of reviewing high-cost claims. Hear from Brian Rubio, Vice President of Products and Emily Ehle, PharmD, Vice President of Operations for Expert Claims Review from Zelis in this HealthPayerIntelligence article: https://lnkd.in/esVG79nc   #AI #Zelis #ClaimsManagement

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Decoding Denial Code 246 By Almas Rizvi Learn how to prevent and resolve denial code 246 in healthcare billing to improve your practice’s revenue cycle. Discover strategies from Claims Med, the experts in revenue cycle management. #HealthcareBilling #DenialManagement #RevenueCycle #ClaimsMed #PracticeManagement #MedicalCoding #DenialCode246

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Thought provoking conversation between our CEO, Mike Desjadon and CNBC's Tyler Mathisen on The Exchange yesterday discussing the role of #AI in driving #transparency and #predictability into #healthpayment. With the technological horsepower of #AI applied to #healthpayment, its now possible to know in advance what benefits are in a plan, what these plans cover and what needs to be done to make sure payments are adjudicated correctly (the first time), and people get the care they need without the anxiety of what what might wind up in their mailbox 30 days later. This is better for everyone, provider, payer and patient alike. We're here for that future. "Payers and providers can partner together on transparency using these technologies" - Mike Desjadon https://lnkd.in/gNinRjXK

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For providers, responding to each of their health plan's information requests can be time-consuming and difficult but is crucial in ensuring patients have access to accurate information. 17 of California’s largest health plans participate in Symphony’s centralized platform, enabling providers to share updates with them all at once. Learn more about how we're streamlining data exchange and reducing administrative fatigue at: https://hubs.li/Q02PmmPK0

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Want to learn how to maximize value in healthcare? We've got 3 Vizient experts sharing insights on redefining care delivery, managing procedural profitability and making data-driven decisions that benefit patients and providers alike. Vizient's Bonnie Lai, Rob Lerman, and Kirtan Patel break down resource stewardship—balancing quality care, costs and operational efficiency, in order to use the right resources for the right patients at the right time. https://viz.inc/3AfPVtS

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Join our upcoming Endpoints webinar where we'll discuss the journey of Claims to EHR Data in RWE. Learn how AI driven insights can help improve patient outcomes.

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It's hard for us at Hippo Technologies, Inc. to believe that, when surveyed, #digitalhealth was only a priority for 33% of C-Suite Executives in #healthcare. Read what our EVP of Health & Business Development, Tom Fee, has to say about the recent Sage Growth Partners. #healthcareinnovation #virtualcare #virtualhealthcare #telehealth #telemedicine #patientcare

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How does a KLAS-recognized Population Health Platform transform amidst complex data challenges? When our client faced decentralized data challenges and slow performance, they turned to Ideas2IT for a solution. The goal was clear: streamline processes, reduce costs, and improve onboarding. Here's how we approached it: - We streamlined data transfer, ensured standardization, and enhanced FHIR bundle processing for seamless data flow. - Powerful dashboards, AES encryption, and real-time data quality checks ensured robust, actionable insights. - A tailored, cost-efficient Medallion architecture cut operational costs by 50% and sped up onboarding from months to weeks. The result was a more efficient, interoperable platform that handles complex data at scale, with real-time quality assurance and better integration across healthcare standards. Want to know how we did it? Dive deeper into the full case study here:  https://lnkd.in/gr2HKGbE #HealthcareModernization #HealthcareInnovation #Interoperability 

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In a recent article on Digital Health Insights, author Jennifer Bresnick discusses how CMS is lighting a fire under payers to compete on value with 1upHealth's CSO Donald Rucker. Topics include the power of modern data standards (i.e., FHIR) and CMS-mandated APIs to provide transparency around outcomes and cost (i.e., value). 🔥 Don says in part, “FHIR creates the ability to bring financial and clinical data together in a meaningful way so that we can finally draw back the veil on why we spend the most but have some of the worst outcomes in the world. We can begin to codify and compute our definitions of value – and start to compete on that value. You can choose to be threatened by that, or you can choose to make it work for you. The organizations that are going to survive are the ones that pick the latter.” 📰 Read the full article to learn more.  https://lnkd.in/eaYdEqBr #fhir #cmsapis #value

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🌟 JUST DROPPED 🌟 Tune in as Charlie Harp explores the taxonomy of the PIQI, Patient Information Quality Improvement, framework. 📊 He breaks it down into two primary categories and four subcategories to show how they are used to analyze and address healthcare data quality challenges. Listen to the full episode now: https://hubs.ly/Q02xhsst0 Stay tuned for our next episode, where Charlie talks about Simple Assessment Modules (SAMs) and the elegant simplicity of recursive failure. #HealthTech #HealthcareIT #DataQuality #Interoperability

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As a healthcare payer, navigating the nuanced healthcare landscape remains complex as costs continue to rise, demographics change, and pressures for affordable, accessible and efficient care persist. At HLTH 2024 in Las Vegas (October 20-23), we're set to help payers discover new ways to uncover new technologies, educate members, and embrace health equity, while improving on quality star ratings and sustaining growth. What’s in it for you as a Payer? ✔️ Critical Conversations: Engage with leaders discussing the biggest challenges and trends for healthcare payers, from rising costs to educating members. ✔️ Tailored Networking: Through our Payer Connect program, connect directly with peers and pioneers, enjoying personalized, strategic 1:1 meetings. This program is ideal for health payers seeking innovative, cost-effective solutions that enhance standard care and streamline workflows. Trending Topics We're Curating 💡The adaption to value-based care models, incentivizing quality outcomes and cost-effective treatments. 💡The utilization of data analytics and predictive modeling to identify high-risk populations and implement targeted interventions. 💡Collaborations with providers and stakeholders to develop comprehensive healthcare solutions prioritizing affordability and accessibility. 💡The impact of breakthrough therapies on patient care and access. 💡The increased focus on reimbursement for preventative health services. Why HLTH 2024? HLTH isn’t just an event—it's where the future of healthcare is shaped! Join us in pioneering payer transformation 🚀 https://ow.ly/eOq550RYIeU #HLTH #BeBold #HealthcarePayers #HealthEquity #HealthInnovation

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