Healthcare

Decisions has been accustomed to empowering billing specialists to write rules, to allow telemedicine devices to report inpatient data, and to assist hospital administrators to define how patients are bedded. By using our rules and workflows engine, the people who understand the processes are able to change the things that really matter. Our earliest partnerships and projects grew from the healthcare space by helping solve problems such as:

HL7 Integration Engine

The Decisions HL7 integration engine helps healthcare providers connect the various practice management systems, legacy systems, and payment systems - reducing data entry and error rates.

Medical Billing

Procedure pricing and billing can create headaches with all the payer policies in today’s healthcare space. Decisions can help manage the billing process to ensure prompt and accurate billing and payment.
 

Interoperability

Given the complexity of healthcare, it’s a common need for different systems to communicate. Decisions can help systems and people communicate, especially if actions are required by individuals or if data needs to be transformed along the way.

Claims Processing

From validating coverage to calculating deductibles, Decisions will help claims processors manage the thousands of rules necessary to manage payments. Decisions' graphical interface enhances the business analyst’s ability to remain current with the ever-changing rules in the clinical landscape.
 

Revenue Cycle Management

From ambulatory care to hospital bed management, to long-term care - Decisions has assisted healthcare providers in the efficient implementation of their revenue cycle management processes.

Collection Management

The Decisions rules engine is helping the collections departments to manage their follow-up. A rules-based follow-up and escalation plan allows time/date based task creation for follow-up specific claims cases.
 

First Time Rejection Rates

Decisions has helped reduce first-time rejection rates, allowing for faster payment and less follow-up. With the Decisions rules engine monitoring the claims process and continuing to build rules, claims rates fall while automation and efficiency improves.

EHR Rules

Rules are found throughout the healthcare space and no more so than in electronic health records. The Decisions rules can help enforce EHR standards from data entry through storage to an interfaced connection to another health care system.
 

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