15 Mar 2018

Healthspace Provider: On Demand Eligibility and Claims Information for Physician Office Staff

Healthspace Provider: On Demand Eligibility and Claims Information for Physician Office Staff

At HCIactive, one of our primary goals is to use technology to make health care administration easier. That’s why we offer providers and physician office staff an effortless way to search for patient information such as claims and eligibility status, benefits coverage information, and ID cards.

To start, Healthspace Provider does not require a username or password to log in. Instead, patient privacy and confidentiality is protected using “exact match” searching. This means that physician office staff must enter all required information correctly to retrieve data. By eliminating this login step, physician office staff doesn’t need to keep track of one more login credential or add an extra step to their already busy day. Information can be accessed quickly and securely.

HCIactive provides a secure, phone-based tool for patient information inquiries as well. Interactive Voice Response (IVR) technology provides a convenient alternative to the online portal. Physician office staff would simply call the designated IVR phone number and input required information at each prompt.

Eligibility Inquiries

Physician office staff may search by eligibility or claims information. To identify a patient’s eligibility, the user must simply enter the required information and the patient and subscriber’s data is immediately displayed. From a single screen, you can view both the member and subscriber’s basic data, member eligibility status (including whether or not their benefits are current), and plan documentation. The documentation is available as downloadable pdf files. This is a streamlined screen to provide the most commonly reviewed data in one place, but if more specific information is required, the Claims Inquiry search provides more detailed records.

Claims Inquiries

The claims inquiry tab is used to access detailed records on a claim made on a specific date by a particular patient. The full explanation of benefits can be easily downloaded as well.

By making it easy to reference basic patient information, accessing claims and assisting patients can be a painless process. As with all our resources, it’s our mission to make technology work for you. Because Healthspace Provider is easy to access and delivers the most patient information on one screen, HCIactive can save valuable time and resources for your physician office staff.

23 Dec 2017

A Culture of Health Reaches Far Beyond the Doctor’s Office

A Culture of Health Reaches Far Beyond the Doctor’s Office

By Henry Cha, Chief Executive Officer, HCIactive

It used to be, you went to see your family doctor for everything. The stereotype is of a kindly physician who handled checkups, shots, and illnesses for the whole family, often for many years. Maybe they even made house calls. These days, though, medicine has become a lot more compartmentalized. You may see one doctor for preventive care, another for cardiology, and still more for allergies, dermatology, etc. Medicine has made incredible strides in the past 50 years, but it’s also lost that individual, personal touch that the stereotypical family doctor was so good at.

One of the lessons I’ve learned in my time as CEO of HCIactive and founder of Habeo Health Plan is that no matter how great new technology and initiatives are, they only work if members engage with them. That’s why fostering a culture of health—whether through a PCMH, a workplace wellness program, or preferably some combination of both—is vital to improving outcomes and lowering costs.

By fostering [a] culture of health at work and providing tools like PCMHs and online member portals to manage patient care, employers create a flow-on effect from members to their dependents.

For example, let’s take a sample employee. Say he’s 45 years old, overweight, and a smoker. He’s likely at risk for a number of health conditions and potentially seeing multiple doctors (who may or may not be communicating with each other). But let’s also say the company he works for has committed to fostering a culture of health. They’ve implemented a workplace wellness program with incentives, resources (including a smoking cessation program), and a self-service online portal to make self-care easier and less confusing. As part of his employer-sponsored health plan, our employee is now able to see doctors at a PCMH. Although he still may be seeing several specialists as well as a preventive care practitioner, they’re now all part of one organization, working together to treat the patient holistically.

Our sample employee is certainly receiving better care under this new model, but his actual medical care is only a small part of a true culture of health. Health isn’t just associated with the doctor’s office anymore; it’s where we work, live and play. By living and working within a culture of health starting at the company level, he is learning new habits and being rewarded for healthy behaviors, like quitting smoking or losing weight. His self-care is likely improving his productivity and lowering his healthcare costs—not to mention the effect it’s having on other members of his household. Studies have shown that behaviors (healthy or otherwise) are often shared among people who live together. If the employee is learning to eat better and exercise more, he’s likely passing on those commitments and better results to his family who, as members of his health plan, also affect healthcare costs. By fostering that culture of health at work and providing tools like PCMHs and online member portals to manage patient care, employers create a flow-on effect from members to their dependents.

Health isn’t just associated with the doctor’s office anymore; it’s where we work, live and play.

It can be scary and confusing for patients and their families to deal with doctors, hospitals, and health insurance. But the education and point of care offered by a strong culture of health can alleviate a lot of those stresses. By helping patients take a more active role in their own care, plan providers and employers can improve outcomes not just for employees, but for families and their communities. It’s the 21st century equivalent of the old family doctor.

20 Jul 2015

HCIactive’s President Henry Cha Among Top Executives Featured in New Report on Healthcare Transformation and Consumerism

BETHESDA, Md. (July 21) — Consumers are emerging as new “power players” in the healthcare arena, exerting greater influence over the design of health plans, the delivery of care, and health promotion activities than ever before.

That’s among the conclusions from a series of interviews conducted by the Healthcare Performance Management Institute with Republican presidential candidate Dr. Ben Carson and top healthcare executives from the likes of the Mayo Clinic and insurer Anthem.

“For the first time, millions of Americans are shopping for health insurance just like they do for other goods and services,” said Dr. Bob Karch, executive director of HPMI. “Consumers increasingly expect to have a more productive and responsive relationship with their healthcare providers. Employers, insurers, and other participants in the marketplace must change their approaches accordingly.”

HPMI has distilled its findings from the interview series into a new white paper. In addition to Carson, the interviewees included the Mayo Clinic’s Jennifer Flynn, Anthem’s Dan Newton, health technology entrepreneur Henry Cha, and Chuck Reynolds, an executive with benefits research consultancy Benfield, a division of Gallagher Benefit services.

Insight from the five experts revealed four strategic imperatives for driving healthcare value: the importance of engaging the consumer; leveraging data to improve care and patient health; the need for new partnerships among employers, insurers, providers, and other healthcare actors; and the centrality of incentives to achieving and sustaining healthy outcomes.

“Progressive healthcare organizations recognize that we are moving beyond traditional risk management to new models that interact more directly and proactively with consumers,” said Dennis Hansen, the founder of Health Synergy Solutions and an HPMI board member. “These models will be supported by tools and incentives that will facilitate our nation’s move towards embracing a culture of health.”


For more information or to schedule an interview with the authors of the HPMI report, please contact Kristen Thomaselli at 202-471-4228 ext. 101 or kristen@keybridge.biz.

To download a copy of the paper, please click here.

About the HPMI

The Healthcare Performance Management Institute (HPMI) is a research and education organization dedicated to promoting the use of business technology and management principles that deliver better and more cost-effective healthcare benefits for healthcare organizations, employers and government entities.