Take on Your Most Pressing Challenge – Provider Engagement

Payspan has designed a quality incentive communications solution that addresses one of your most obstinate challenges – how to get your providers to engage in value-based care so your organization can boost CMS Medicare Star Ratings and drive revenue.

Our Quality Incentive Communications System (QICS) leverages our secure healthcare epayments network to enable the electronic exchange of quality information via attachments. Health plans share care gap notifications, guidance on quality measures and incentive reports over the network with providers who, in turn, share proof of care gap closures to receive incentives.
Our solution enables your health plan to:

  • Offer simple care gap notifications per individual member-patient.
  • Deliver timely provider incentive reports to equate performance with dollars earned.
  • Provide clear communications about incentive opportunities missed, as well as incentives available to be earned per provider, patient and/or care gap.
  • Help providers reduce administrative labor and costs associated with manual processing of quality communications.
  • Magnify the value of financial incentives to the bottom line.
  • Automate your manual process and postage costs for paying and communicating about quality incentives.

Providers merely enroll in our network one time, and they have instant access to your organization and multiple other health plans. They no longer need to manually enroll and follow up on each health plan’s website. When they see how easy the process is and how little administrative time and effort is required, participation becomes appealing to them.

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Quality Incentive Communication System (QICS)

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Actionable Incentives

The lack of provider adoption of value-based care contracts is often linked to cumbersome and hard to understand quality contracts and metrics exchanges that do not clearly deliver insights into incentive progress.

QICS removes the complexity by translating raw data from health plans about their patients into clear, simple, visually appealing notifications about existing care gaps that providers can easily read and act on quickly. Our graphical reports about attained and available incentives offer insights into their value-based contracts while helping providers track and monitor progress with each patient with a care gap. As a result, your providers are empowered to improve care outcomes while boosting their revenue.

Quality Notices

Quality Notices give payers the ability to deliver open member care gaps to providers, as well as the potential incentive available for closing those care gaps. This information is presented within their existing payments automation platform, meaning both providers and the back-office can discover new and additional care gaps to close for enhanced provider revenue opportunity.

When a provider is alerted to an open care gap they have closed, but have not submitted proper documentation for, they can upload the necessary attachments via the Medical Records Exchange.

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Quality Electronic Attachments

QICS supports electronic transmission of medical documents between payers and providers and offers information about care gaps, quality measures, and incentive reports which can boost provider revenue. When payers electronically deliver Quality Notices directly to providers, this communication gives providers the opportunity to close care gaps leading to better patient outcomes and faster incentive payments for the provider. The results:

  • Improves Medicare Star Scores
  • Quality notifications that alert providers about care gaps
  • Promotes improved clinical outcomes for patients
  • Accelerates Quality Incentive payments

Medical Records Exchange

Payspan’s Quality Incentive Communications Systems features a robust Medical Records Exchange (MRE) platform that enables the electronic exchange via attachments of quality information between health plans and their providers. Health plans share care cap notifications, guidance on quality measures and incentive reports with providers who, in turn, share proof of care gap closures to receive incentives. This bi-directional tool enables you to deliver messages to your entire provider network within our payment platform.

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On Demand

Payspan is able to leverage your existing data and transform it on-demand into actionable insights for providers to deliver enhanced patient care. Because the data is available directly to the provider and it’s always the most current data, this creates improved provider engagement and patient care. The data can be delivered through Payspan’s online portal or white-labeled solution integrated into provider management systems or payer portal.

Free EBook:

Free EBook:

How to Drive Provider Adoption of Value-based Care by Leveraging Electronic Payment Networks

Discover how health plans can share and exchange sensitive medical information with providers about care gaps, quality measures and available incentives to improve care delivery and patient outcomes.

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Connect with our team today to discover how we can architect a customized solution to accelerate your value-based care program and harness your reimbursement pipeline to deliver Quality Incentive Communications, and improve your current Payer-Provider-Member relationships.