Health 2.0 is where a lot of digital health companies get launched and this year was no exception. Healthline Networks took a slightly more unconventional approach and launched a subsidiary business, Talix.
Its first Software as a Service, Coding InSight, zeroes in on the challenge of optimizing reimbursement codes for physicians, accountable care organizations, and payers. Specifically, it analyzes structured and unstructured clinical data to flag up patients where the reimbursement code should be changed.
Talix General Manager Derek Gordon provided a demo of Coding InSight at the conference. Its software is embedded in electronic medical records. He said it predominantly works with mid-tier EMR providers such as NextGen, which tend to have app stores and sandboxes. It is the first of a series of risk adjustment apps for the business.
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The platform is meant to help providers to screen for uncovering prospective and/or missed coding opportunities in near-real time. A high risk patient may be one with one or more chronic conditions that could impact the kind of reimbursement code that should be assigned for a particular interaction.
“Coding can be a lengthy, error-prone process,” Gordon noted. “Healthcare providers and payers are leaving money on the table because they don’t know how to optimize coding.
He added: “This is real IP solving real problems in healthcare. I see so many superficial applications addressing problems that only tangentially exist and have no real ROI attached.
Healthline is a 10 year old business with heath and wellness content as a big part of its business. But it has also had a division that developed customized solutions for its clients. “Now we’re here as a product company that solves specific problems,” Gordon said.
