Healthcare

Practical, collaborative, realistic solutions that enable better healthcare.

>Healthcare
Healthcare 2018-09-07T15:54:29+00:00

Proven Leadership and Results in Healthcare

Over the past decade-plus, we’ve helped create digital, operational, procedural and financial solutions for our healthcare clients. Our dedication to practical, collaborative relationships and successful execution is a part of what makes the SDLC Difference.

For Health Plans

For health plans, your goal might be to scale and take your care management program digital, transform your claims or revenue management processes for efficiency or streamline quality reporting to enhance STAR ratings, or create new tools to help extend sales and member engagement efforts.

For Provider Organizations

Your goal might be to scale and take your care coordination, telemedicine, or patient engagement program digital, improve satisfaction scores and consumer loyalty, streamline operational and business processes or improve revenue cycle management.

Learn more about our available stand-alone solutions and API, below, or explore our Healthcare Case Studies.

Sample Digital Solutions Created for Healthcare

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Care Management Solutions

SDLC’s cohort care management solution is designed to help payers and providers accelerate the shift in healthcare from fee-for-service to value-based care.

It is designed to enhance interactions between patients, caregivers, and care managers to improve outcomes and the patient experience.  Our preassembled building blocks help healthcare organizations quickly and cost-effectively define and assign members/patients to cohorts, collaboratively develop care plans, customize workflows to optimize the productivity of care managers, as well as measure and report results.  Embedded AI optimizes care plans and workflow development. Our balanced scorecard-style dashboards include key operational measures, outcomes and align to other value-based measures.

Using our framework, we developed a solution that helps the primary care team manage the health of high-risk, chronically ill patients, as well as collaborate with extended care team members — specialists like physician advisors, behavioral health specialists, pharmacists, and social workers — as well as auxiliary services like home care specialists, post-acute care programs, complex case management partners, and local community health networks.

Also, we created a care management mobile app that enables case and disease managers to navigate logistical, resource, and care challenges while working with members in the field. Our solution enables the power of member data, streamlined workflow, and complex logic to assess and solve barriers to care with the goal of improving outcomes and optimizing interactions – both ensuring necessary high-value intervention and avoiding unnecessary interventions.

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Claims Management Solution

This technology utilizes a GUPe framework to apply business rules to claims data and create a more efficient, auditable and configurable submission customized to meet each state’s Medicaid regulations. It creates Medicaid Encounters for state submission, develops X12 837 I files, as well as receives state response files and format error records to be resolved by a Medicaid operations team.

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Product Configurator Solution

Product Configurator empowers product development, sales, and marketing teams to create health plan designs that conform to government mandates and be operationalized in downstream systems while generating internal and member-facing documents.

It minimizes development and maintenance effort, decreasing the time it takes to make large modifications to business rules because of evolving government mandates.

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Product Value Visualizer Solution

This application empowers sales managers to guide their clients through informed decision making when selecting effective health insurance alternatives.

The tool provides appealing dashboard calculators that provide solution snapshots and savings, as well as disruption analysis based on an employer group’s claims for the last 12 months, including how much claims would cost with a new network.

It’s on-the-fly, real-time levers visualize the impact on provider and network changes and effects on quality, cost, and access. Plus, create handsome, customized leave-behind materials instantly.

Healthcare-App_Physicians Referral

Physician Referral Solution

Physicians highly value technology that connects them seamlessly to other physicians. The physician referral technology keeps key referral information centrally located for easy data retrieval and referral decisions. It improves communication between physicians and other independent groups and allows physicians, included in a network directory, to view specialist qualifications, as well as generate, respond and track correspondence concerning patient referrals.

Healthcare-App_Consumer Health Plan Calculator

Consumer Health Plan Calculator Solution

This B2B calculator allows employer groups to receive insurance plan recommendations and premium estimates by entering basic company information. It generates plan recommendation and premium estimates from basic company data, as well as empowers employer groups and sales to find the right solution and work with clients from any device, anywhere.

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