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Insurance Solutions — Benefits & Eligibility
The Health Sciences Universe™ product provides financial solutions that take advantage of the product's unique ability to create a complete financial picture of a facility, group, person or family.
The product allows the combination of financial, administrative and clinical data from multiple sources of risk:
- group and personal health benefits
- self-reported and provider reported clinical information
- disability and worker's compensation benefits
- value functions and cost effectiveness measures
- quality and safety measurements
- reinsurance rules based on actual losses by group or person
- real-time eligibility checking
- enrolled and non-enrolled services
Benefits can be assigned to persons, groups, special risks classes, reinsurance groups and can also be rule-based for special circumstances. The product includes all the insurance classifications (employer, group, policy, rider, rules and exceptions) required to create custom insurance and most importantly, clinical solutions for a person, family or employer.
Eligibility
Also, the product uses internal languages Enterprise Clinical™ and Enterprise Financial™ that can be employed by analysts to create financial metrics combined with clinical metrics to build risk profiles of people, families and cohorts to create financial risk management and disease management programs based on benefits and eligibility rules.
Eligibility rules can be created to determine in real-time if a person is eligible for a financial or clinical service and executed remotely at the point of care or in any mobile health setting.
Services can enrolled (based on an insurance rider or policy or non-enrolled such that a person may chose a service at will, for example, a wellness program.
Perseid Software provides insurers with the integrated care technology required to implement total quality management programs for employers and to build and operate employer clinics.
The Health Sciences Universe™ product provides integration of the clinical and financial risks and has extensive tools for monitoring care to avoid hospitalizations and re-admissions.
Hospitals require new technology to create and manage wellness and disease management programs that extend the hospital's reach into the community: to employers and families where they live and work.
The Health Sciences Universe™ product provides integration of the clinical and financial information you need to reach out to the community of care managers and families by creating a single enterprise view of all relevant current information on a patient, their services and their clinical and financial programs.
Perseid Software enables payers to manage the integration of clinical, financial and administrative information on employers and their employee's family to create an enterprise view of the state of a patient financially and in terms of future risk..
The Health Sciences Universe™ product provides integration of the clinical and financial information you need to create for client communities wellness and disease management programs that capture value, defer the onset of chronic illness and reduce hospitalizations.
Payers can develop new programs for self-insured companies or large enterprises to take control of healthcare costs by manage the integration of clinical, financial and administrative information on employees and their families to implement innovative solutions for group health, disability, safety and occupational health.
The Health Sciences Universe™ product provides integration of the clinical and financial information you need to create safety, wellness and disease management programs create capture value, defer the onset of chronic illness and reduce hospitalizations by uniquely integrating group health, personal and family care, disability, worker's compensation and reinsurance solutions into a complete enterprise program for health and care management.
Perseid Software enables payers to take control of healthcare information systems to improve the quality (and quantity) of care to create centers of excellence that clearly show employers the value being created from their ASO services.
The Health Sciences Universe™ product provides 10 applications, thousands of healthcare, clinical and insurance forms, reports and packages of code for the development of clinical and financial information systems. The product uniquely integrates CDR and PHR records, group health, personal and family care, disability, worker's compensation and reinsurance software solutions into a complete enterprise product for health and care management.
Perseid Software enables payers to develop enterprise-scale applications for developing state and local government solutions that can manage large populations of patients.
The Health Sciences Universe™ product provides 10 applications, thousands of healthcare, clinical and insurance forms, reports and packages of code for the development of clinical and financial information systems, including those needed to reduce costs and enhance care in Medicaid, Medicare and Military health systems. The product uniquely integrates clinical medicine and trials, group health, personal and family care, disability, worker's compensation and reinsurance software solutions into a complete enterprise product for health and care management with enterprise scaleability and the required security, access and control systems for government use.
The technology for payers requires only a workstation for a care manager, employer representative or a mobile device for a patient and a server somewhere operating Oracle. Perseid's technology does not require constant downloads and updates. No programs are ever maintained in the payer's workstations so the complete solution is available anywhere in the world from a simple computer with a browser: patient's home, office, on the move, hospital, clinic.