Informatics In Context, Inc.

Informatics In Context, Inc.
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Streamlines & automates prior authorization & referral process via 278 EDI. For Providers: We portal-web service checks eligibility, submits referrals & PAs to all payers in providers network. Data is reconciled against payer-policy guidelines. For Payers: 278 EDI Adjudication engine, based on configurable payer policy guidelines, deployed as a secure web service. It offers advanced data analytics and can be extended to use Appropriate Use Criteria to propose alternate clinical treatments

Informatics In Context, Inc.

 •  November 14, 2016

BOSTON--(BUSINESS WIRE)--Harvard Pilgrim Health Care, Inc. (HPHC) and New England Health Exchange Network (NEHEN) deployed Informatics In Context’s (IIC) EDI 278 real-time prior authorization engine in limited production, automating HPHC’s prior authorization process today. Selected provider groups are now able to submit prior authorization...

Informatics In Context, Inc.

 •  August 4, 2016

UPDATES Pre-Claim Review Demonstration for Home Health Services Officially Began in Illinois on August 3, 2016 As the Pre-Claim Review Demonstration for Home Health Services goes into effect in Illinois, we are instructing Home Health Agencies (HHAs) in Illinois not to submit pre-claim review requests for episodes of care that began prior to August...

Informatics In Context, Inc.

 •  February 11, 2016

CMS Finalizes Rule Creating Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Items (CMS 6050-F) The final rule for prior authorization for durable medical equipment, prosthetics, orthotics and supplies was published on December 30, 2015. While the final rule itself is effective February...

Informatics In Context, Inc.

 •  September 7, 2014

A survey of hospital executives has determined that the U.S. healthcare system spends at least $7.47 billion, and as much as $11.95 billion on unnecessary imaging every year. The survey and accompanying report--performed by the consulting company peer60--included data collected from executives, including chief medical officers, chief medical...