SOURCE: SCI Solutions

SCI Solutions

November 11, 2015 09:00 ET

SCI Solutions Offers Platform to Streamline Insurance Authorizations

Delivers on Promise of Single Platform to Seamlessly Address Industry Need for Integrated Patient Referral Management, Insurance Authorization and Scheduling

SEATTLE, WA--(Marketwired - Nov 11, 2015) - SCI Solutions, the health industry's leading patient access, referral management and care coordination software firm, today announced the availability of insurance processing and authorization services, adding to its revenue cycle workflows and supporting end-to-end patient coordination across care communities.

This offering combines a proprietary analytics platform, enabling adherence to health plan payment and utilization guidelines, with a world-class service organization to deliver quick, accurate insurance authorizations. The insurance processing capabilities are embedded within SCI's Provider Network Manager® solution, a patient referral management platform, enabling SCI clients to more rapidly convert referrals into insurance-approved, schedule-ready appointments, ensuring payment of services and delivering an enhanced provider-patient experience.

Diagnostic Health Centers, headquartered in South Carolina and the largest provider of outpatient imaging services in the markets it serves, has successfully deployed SCI's insurance processing and authorization services in its Beaumont and Port Arthur, TX markets. The insurance authorization service allows Diagnostic Health to offer referring providers a more simplified process for requesting and tracking authorizations for imaging services. Diagnostic Health will also be able to handle a higher volume of orders, have better payment data and schedule appointments more rapidly with fewer resources. 

"The growth and viability of our business depends upon delivering an advantaged service experience for patients and referring providers alike," said Ed Field, director of imaging for Diagnostic Health Centers. "By adding insurance authorization services to the Provider Network Manager platform we already use, Diagnostic Health now offers referring providers a streamlined process to request and receive authorizations for imaging services. Patients benefit, too, from shorter approval times, more accurate insurance payment requirements and better communication between their referring providers and the imaging center, thus shortening the diagnosing time and getting to treatment faster."

Health systems and providers spend between $23-$31B every year interacting with health insurance companies regarding payments and authorizations, and lack of authorization is a leading cause of payment denial. SCI's solution addresses this growing need for care coordination technologies that can help providers avoid costly insurance denials and help bring increased reimbursement transparency to the front end of the revenue cycle.

"As the industry shifts to a value-based system of care, our clients are turning to SCI for reliable methods of improving their competitiveness and increasing patient satisfaction," said Joel French, SCI's CEO. "Insurance prior authorization requirements and related payment denials are high-priority pain points for providers. Diagnostic Health demonstrates how easily SCI clients can improve their referral-to-appointment conversion without leaving existing workflows."

Earlier this month, SCI Solutions announced the acquisition of Seattle-based Clarity Health, a software-as-a-service company delivering insurance authorization and referral management services, enabling SCI to fulfill a growing need for insurance processing and authorization services in the market. Through a distribution and technology integration agreement jointly executed by SCI and Clarity Health in 2014, the solution is already being deployed among existing SCI clients, resulting in rapid adoption and substantial sales of the insurance authorization service.

About SCI Solutions
SCI Solutions improves the health of the healthcare system by enabling provider networks to gain economic value through better community-based care coordination. By operating a cloud-based service for more than 10,000 physician practices and 700 hospitals, health systems and imaging centers, in 275 geographic markets across the United States, SCI connects health systems beyond their traditional boundaries to their community partners in ways big IT systems can't. Provider networks utilize SCI's service to coordinate patient care transitions, obtain insurance pre-authorization, schedule patients, automate referrals and manage orders. An integrated and easy-to-use business analytics toolset identifies opportunities and monitors performance. As a result, healthcare organizations experience increased outpatient revenue, better coordinated care and greater physician satisfaction. For more information, visit scisolutions.com.

About Diagnostic Health
Diagnostic Health Centers provides cost-effective, high-quality imaging services in a patient friendly environment. Focusing on controlling the cost of providing imaging services while emphasizing high levels of service for referring physicians and patients allows Diagnostic Health Centers to be a major player in the markets we serve. The continual growth of our IT platform has allowed us to improve communication with patients, providers and payers in this very challenging healthcare system. This uniquely positions Diagnostic Health Centers to expand our network in a cost-effective and meaningful manner through the use of scalable solutions that are tightly integrated to maximize the impact to our businesses. For more information, visit dxhealthcenters.com.

Contact Information

  • Contact:
    Collin Roberts for SCI Solutions
    Email Contact
    (206) 664-7839