Let’s put this simply: For decades, when it’s come to radiology, health insurance companies haven’t gotten what they were paying for – literally. That is, insurance companies have never received a copy of the actual imaging they paid for.
Yes, health plans receive claims submissions and pre-authorization requests for radiology. But imagine if a health plan had access to all of their patients’ imaging, delivered in real-time before its patient’s feet even hit the floor?
Imagine the fraudulent claims for imaging never taken that could be virtually eliminated. Imagine the claims for redundant and duplicate imaging that could be stopped at the pre-authorization stage, because you knew that clinically appropriate prior imaging had been taken only days before. Imagine being able to deploy that imaging in diagnostic quality for a legitimate second opinion, but without having to pay a claim for a second imaging procedure. Imagine real-time Quality Assurance, to ensure that you aren’t being double-billed for a poor-quality image. Imagine the empowerment to do Medical Necessity reviews like never before.
This all sounds great, but this idea poses its own set of problems:
How would you get it all to one place? All of this radiology imaging is sitting on thousands of individual storage systems (called PACS storage arrays) in individual radiology clinics all over the country.
Once there, where would you put all those images and data? How would you store it all? Radiology imaging is big – each digital file can easily range into gigabytes. Over weeks and months, we’re talking hundreds of petabytes of storage (thousands of terabytes, or millions of gigabytes – trust us, it’s big), not to mention the bandwidth involved.
Now that you have the information, how do you make sense of it? When you’ve got terabytes of information flying at you every day, the raw data alone is next to useless. Without help, it would take vast armies of personnel to make sense of this potentially valuable new data.
Leveraging a suite of first-of-its-kind technologies and a cutting-edge cloud-based platform, MediSKY's Radiology Accountability Solution is bringing Accountability to Radiology. Our revolutionary solution gives health plans, ACOs, and RBMs access to all of their patients’ radiology imaging in real-time, before their patients' feet even hit the floor.
Fraudulent claims for imaging never taken - virtually eliminated. Claims for redundant and duplicate imaging - stopped at the pre-authorization stage. Prior imaging securely deployed for a second opinion - without paying a claim for a second imaging procedure. Real-time Quality Assurance - a reality. Medical Necessity reviews - empowered like never before.
Of course, we've solved all the technical problems. Our suite of proprietary technologies is powered by an enterprise-level, HIPAA-compliant, kernel-based cloud computing platform spanning multiple secure data centers, designed by a former CIO to multiple HMOs and consultant to the Centers for Medicare & Medicaid Services.
Our Radiology Accountability Solution serves as a centralized repository for all of a health plans' patients' radiology imaging, providing each patient with a unified radiology record reaching across all healthcare providers. Our solution also assembles a massive relational database of patient imaging, underlying metadata and claims data, all of which is made available to health plan personnel and analyzed by our proprietary suite of algorithms. By analyzing the health plan's claims data, MediSKY matchs each radiology claim to its corresponding imaging, automatically flagging fraudulent claims and notifying health plan claims personnel.
Radiology viewing is revolutionized as well. For the first time, health plans, radiologists, and referring physicians will all have access to remotely-deployed diagnostic-quality imaging, available instantly, without downloading large files or waiting on archaic CD delivery.
MediSKY Technologies' Radiology Accountability Solution is compatible with every major PACS system on the market today, meaning that without any additional software and hardware, MediSKY can be rolled out to your health plans' in-network radiology clinics with minimal effort. After setup, all of a radiology clinic's imaging for a MediSKY customer health plan or ACO will be directed securely to our enterprise-level, HIPAA-compliant set of data centers.
MediSKY Technologies is here to help you save a significant amount of money. We can start integrating you into our revolutionary system within a matter of days, making your savings nearly instantaneous. Contact us today and learn how we're here to bring Accountability to Radiology.