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A pharmacy information system or a pharmacy management system is used in pharmacies. This system provides basic to advanced pharmacy functionality. After verification, the system can store data and have features that support safe medication delivery. Pharmacies can use this technology independently or as a larger hospital administration system module. Pharmacy management software can have a user interface, automated data entry, data retention, strong encryption for data privacy. Pharmacy management software can either be commercial off-the-shelf software or customized. Most pharmacies are turning to customized software to build custom pharmacy software system . This is because it enables pharmacies to prevent functional wastage. Pharmacies are also using cloud apps more because of their flexibility and scalability. What are some of the features of a pharmacy management system? Listed below are four significant features of the pharmacy management system. Managing prescriptions Prescript...

A healthcare providers’ network is a group of doctors, and other healthcare providers like physiotherapists, home caregivers, clinics, and hospitals included in an insurance payer’s health plan. Each of those entities would have undergone an elaborate process of being onboarded into the plan. This process is called credentialing and it involves a series of verifications, processing, checks, documentation, and paperwork.  A provider network would have individual medical entities operating on a day-to-day basis, and those operations involve medical care, coding, billing, claims, and so forth. The operational efficiency of the network is of concern to the payers since they are the ones who would be footing most of the bills. It is why providers invest significant amounts of resources into healthcare provider management solutions. It used to be one of the most overlooked aspects at insurance companies. But it has undergone significant changes over the last few years as insurers have r...

Clinical Data integration collects information from different healthcare sources into a single format. It uses components such as healthcare data sources and a master server and avoids unstructured data. The healthcare sector struggles with health integration platforms and maintaining structured data. Structured vs. unstructured data can be understood by considering the who, what, when, where, and how of the data. Integrated health provides the best quality care services to the patients. Healthcare professionals work under tremendous pressure and are pressed with time. They deal with maintaining healthcare organizations, staff, and improved patient care. Administrative tasks and advanced paper works become cumbersome for healthcare providers. Healthcare professionals struggle with unstructured data. That is why  a healthcare automation solution  is needed to bring efficiency to the managed care continuum. Healthcare integration assigns patients to different primary care physi...

  Nearly every day, the healthcare industry deals with vast amounts of data of patients, healthcare personnel, and institutions which could be time-consuming and exhausting. However, manual data entry can affect the accuracy and reduce the efficiency of care services. Hence the integration of EHR systems with healthcare practice management models streamlines adding, updating, and sharing patient data online. A patient management system is frequently linked to an electronic health record system. While some data in these systems may overlap, the EHR system track patients' clinical outcomes. In contrast, the patient management system is used for administrative and financial matters such as medical claims processing in healthcare. One of the more difficult decisions for modern medical practices is connecting the two systems or purchasing an integrated software package. To promote increased operational efficiencies and comprehensive efforts like population health management systems and...

Claim denials are one of the prime reasons millions of dollars are lost every year. To reduce and manage denied healthcare claims, providers often look for better options in the market. However, they fail to realize that they already own the best tool- denial management .  Denial management can be integrated or availed in the facility itself, and it does not require looking for extra solutions. A strong denial policy and affirmed procedures often lead to a reduction in medical denials.  Denial management- definition The process of claim denial management is formed of two parts-first is the identification of denial, and the second is its investigation. Together, these two steps form a strong basis for the performance of denial’s root cause analysis. This also incorporates monitoring denial patterns and uncovering trends by insurance careers. As the final step, claims denial management should seek to redesign the process of the system to prevent and eliminate the risk of de...

  Patient engagement is a concept that aims to educate and enable patients to manage their own healthcare and wellness better. It does so first and foremost by improving the interaction between doctors and patients. The process of healthcare has always been about doctors talking and patients listening and following their advice. In other words, it has been unidirectional. But patient engagement in healthcare aims to change that. That is because real care happens when the patient leaves the clinic. Patients need to be better aware of the pills they consume and the treatment they will undergo. Moreover, they also need to be made aware of the condition that ails them, and how they got it. It could be because of unhealthy lifestyle choices like smoking, drinking, fast food; or it could be hereditary, or for a myriad of other reasons. Only when the patients know more about their conditions and how they contracted them in the first place, would they be in a better position to participat...

  Big data analytics is one of the hottest buzzwords in the entire data analytics industry. In simple words, big data means data sets that are too large to be assessed using conventional analysis methods. The range of big data has been moving upward over the last few years, but today, it is generally accepted that data sets in the range of a few thousand terabytes to a few exabytes can be classified as big data.    The appearance of such large chunks of data in healthcare can be attributed to the rapid pace of digitization across the industry. Additionally, medical wearables such as Apple’s smartwatch and Fitbit, in addition to smart garments, also generate real-time data about users’ vitals. Furthermore, applications for medical billing, insurance claims, and electronic medical records are all brimming with users’ medical data. Increasing digitization will only increase the size of this data.    This heap of data undoubtedly contains a ...

Every business in every industry runs its operations according to certain parameters. Needless to say, all of them generate operational data that holds valuable insights about various aspects of the business. As a result, data analytics has emerged as the hottest skill set that all companies, small and large, have begun looking for. Whether it is an airline, a chain of hotels, fast food joints, a shipping corporation, a software company, or even a financial services provider - every company needs data analytics. Healthcare is no different. Healthcare payers are an integral part of the overall industry. No doctor in the United States offers his or her services without knowing that he or she will be reimbursed for it by a payer. In light of such ubiquity, Provider analytics has shown great promise in helping payer organizations to streamline operations and boost productivity. Most of all, it helps insurance payers to analyze provider patterns, namely bundled payments, and evaluate costs...

  As the name indicates, risk management for hospitals is just that – managing the risks that might arise from day-to-day administrative and medical operations. The task has become so important that there are designated professionals called risk managers. The job of a risk manager and his or her team is to analyze various processes and determine which ones might lead to any problems for the hospital. Moreover, the team for risk mitigation also devices various protocols that doctors, nurses, radiologists, pathologists, the insurance department, and the   medical billing   department must adhere to.   These protocols are designed after thoroughly considering existing government regulations, and any eventuality regarding treatments, medical claims, reimbursements, out-of-pocket payments, and consultations are assessed for legal consequences. Risk managers are specifically trained to identify these scenarios and act accordingly before any of them can cause har...

  Value-based Reimbursement in healthcare has been touted as the best alternative to the conventional fee-for-service model. In this model, providers are reimbursed based on the outcome of the patients’ health. In other words, doctors won’t just be paid based on the number of services they provide, but on the patient’s overall health situation they engender. Consequently, this encourages and incentivizes providers to ensure that patients live healthier lives and manage their disease better.   Value based payment systems Policymakers and researchers intend value-based Reimbursement in healthcare to be a silver bullet solution for improving the quality of care, promoting superior population health, and lowering the cost of care. That is an expected outcome since there is an emphasis on the quality or value of care given instead of care volume.