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Revenue Cycle Management and Fraud Prevention

Revenue Cycle Management and Fraud Prevention

Healthcare organizations using contracting initiatives benefit from automation using blockchain smart contracts to administer bundled payments and reimbursement models on blockchain. Smart contracts on blockchain allow for real-time claims administration and settlement processes, as well as Explanation of Benefit (EOB) statements, at the point of care. Claims are quickly validated using machine learning across historical claims and remittance data, and claims administration, using smart contracts on distributed ledger technology, allows hospitals and health systems to settle claims in real time and generate EOBs for health plan members at the point of service. The First Genesis BPaaS™ revolutionizes healthcare data security, improves...

Population Health Management

Population Health Management

The First Genesis BPaaS™ delivers a population health management solution with seamless data integration and visualization. Our MOBIUS HISE BPaaS™ is an innovative platform, which integrates all types of healthcare data to ensure that physicians have access to a Comprehensive Health Record and can make quality decisions based on all the relevant information.   Our Partnership with The Sequoia Project provides technology with the capability to connect seamlessly with all Electronic Medical Record platforms.  The First Genesis BPaaS™ provides custom solutions that enables stakeholders to analyze vast data sets to identify at-risk patients and those in need of proactive intervention....

Payer Administration of Comprehensive Health Record Data Exchange

Payer Administration of Comprehensive Health Record Data Exchange

Medicare receives $4.8M insurance claims per day.  The Center for Medicare / Medicaid Services’ (CMS) Office of Financial Management estimates that each year: The Medicare program issues more than $28.8B in improper payments annually, that’s an error rate of 8.6% The Medicaid program issues more than $21.9B in improper payments annually, that’s an error rate of 8.1% Most improper payments can only be detected by a human comparing an insurance claim to the medical documents.  Claim review contractors currently receive 78% medical documentation in paper form or via fax. Administrative tasks such as claims processing and underwriting benefit from a blockchain...

MOBIUS Health Information Services Exchange

MOBIUS Health Information Services Exchange

One of the proudest moments in our company’s rich history occurred when Military Health Systems began to explore the establishment of a nationwide health information network in 2008 selecting the First Genesis team to provide their Subject Matter Expertise in the architecture of what is now known as the e-Health Exchange.  The First Genesis team had the prestigious honor to sit on the initial commitment of the Office of National Coordinator for Health IT in creating the standards for connectivity and interoperability for the E-Health Exchange First Genesis has created the first HIPPA compliant interoperable e-Health Exchange solution that is...