Using technology, analytics and processes to help the health system:
There are five basic components to designing an integrated risk adjustment and quality program:
- Analytics
- Targeting
- Intervention
- Submission
- Compliance
Realizing the promise of value-based care:
from comprehensive clinical data to actionable analytics, several factors contribute to successful population health management implementation. Listen to our podcasts to gain insight on the key issues for health care organizations considering their transition from fee-for-service to value-based care.
Manage compliance NPHIES, CHI & MOH with medical necessity requirements on every patient case:
Medicare and Medicaid reimbursements represent a significant portion of most providers and payers operating revenues
- payer denials management
- Provider denials management
Bussma Products
- Bussma Integrated Healthcare solutions HealthCare expenses increasing Rapidlywith Bussma Control, Monitor, Analyzeand manage Expenses
- Bussma Medical Edits Rules Authorization, Eligibility, Claims Submission & Resubmission To Serve Insurance Companies, TPAs, Hospitals, Clinics & Regulators
- Bussma ERP & CRM Solutions Clouding system, Easy to use & User friendly
Bussma Medical Edits & PBM are well authorized and compliant with Regulators such as NPHIES, CHI, MOH, UAE, KSA, and others
Bussma Bussma enables checking and alerting on potential mistakes and reviews in medical coding Medical Necessity Checks &eRX Interaction all our edits are accredited and authorized to meet international standards of WHO
Bussma is totally independent and is based on guidelines from recognized bodies such as CMS, AMA, ADA, local authorities, and other recognized societies.
The Bussma Knowledge Base provides all healthcare information systems Insurance management,ePrescription , codes edits and more - with the medical edits, medical necessity and drug data, and SDK necessary to integrate medical and drug data in a way that best meets clinician's needs for maximum functionality and usability.
Bussma solutions welcomes any other ways of integration by clients
It is time for Payers and Provider to collaborate creating value for patients which is both the ultimate goal and an increasingly critical competitive advantage for health care payers and providers worldwide. Payer organizations are being challenged to manage funding gaps and improve the care of members within a changing regulatory environment. Bussma Health care enable provider transforming their business models to deliver cost-competitive services that improve patient outcomes and deliver sustainable growth for the organization.
Check for possible interactions between a patient's entire medication regime — including prescription, OTC, herbal, supplement or foods. The most powerful drug interaction checker available, Bussma Solutions provides a ranked listing of all possible interactions, and a description of each reaction. Includes: Drug to Drug – Drug to Allergy – Drug to Nutrient – Drug to Alternative medicine – Drug to food … etc
- Drug-drug
- Drug-allergy
- Drug-nutrient
- Drug-alternative medicine
- Drug-food
Bussma letter to Providers & Payers about ICD-10 / ICD-9 Grouper readinessBussma has issued letters to hospitals and insurance companies Fee-for-Service providers emphasizing the importance of readiness for ICD-10 and reminding them of the resources available from Bussma Solutions to meet their requirements from NPHIES, CHI & MOH or any international regulatory authority
Experience medical cost savings and improved patient health through innovative and unique Bussma Services for payers & providers, with Medical Necessity Edits, PBM and Drug Data Base
Project Initiation:
• Review scope
& objectives
• Prepare detailed project plan
• Prepare Communication Plan
• Steering Committee Initiation
• Agree deliverables acceptance
Current Situation Assessment
• Study of the existing business processes
• Identify the problematic areas
• Redesign and recommend improvement to the business processes “To-Be-Processes”.
Development & Implementation
• Configure solution
• Prepare Data Templates
• User training
• prototype design
• Fine tune design
• Re-test the system
• Migrate Date
• Verification of the production
Go-Live & Post-Implementation
• Go Live Readiness Assessment
• Go - Live
• On Site Support