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What is PwC SMART?

PwC's Systematic Monitoring and Review Technology (SMART) significantly improves the efficiency and effectiveness of assessing the quality of both inpatient and outpatient coding processes while creating a robust framework for quality assurance and compliance evaluations. Supported by PwC Health Information Advisory, SMART strengthens your approach to monitoring coding accuracy and enhancing overall data quality. The inpatient module of SMART includes more than 1,000 predefined business rules aimed at identifying possible coding mistakes and opportunities for improving documentation, with flexibility to customize rules according to specific organizational needs. Its extensive reporting and data analysis features facilitate the evaluation of staff performance and highlight areas that require educational focus, such as Coding, Clinical Documentation Improvement (CDI), Quality, and Providers. Moreover, the outpatient module enhances claim accuracy and brings attention to issues concerning charge capture and the optimization of workflow processes. By addressing the risks associated with inaccurate coding, the system also promotes better regulatory compliance, ultimately leading to advantages for the entire healthcare organization. Furthermore, the combination of these modules effectively simplifies the coding review process, thereby ensuring elevated standards of care and improved operational efficiency, which can significantly impact the overall success of healthcare delivery. In this way, organizations can not only enhance their coding practices but also contribute to a higher quality of patient care.

What is HealthQx?

Enhance the effectiveness of your value-based initiatives by quickly assessing and understanding the costs linked to episodes of care. Encourage active participation from providers by initiating discussions that are grounded in data and evidence concerning total episode costs and the individual practice patterns of providers. Drive improvements in both cost efficiency and quality by tackling inconsistencies in care delivery and performance across different providers. Leverage analytics to support value-based strategies, delivering insights that aid in optimizing network configurations and fostering clinical advancements. Identify potential avenues for value-based care through a thorough analysis of episode costs, utilizing clinically validated definitions to frame these episodes. Involve providers in discussions centered on value by scrutinizing patterns of utilization, expenses, and differences in care practices. Use episode analytics to fine-tune network designs, update clinical guidelines, and enhance consumer engagement in a meaningful way. Make the process of budgeting for episodes more straightforward by determining average costs per episode along with relevant clinical services, ensuring a clear understanding of financial responsibilities. This targeted strategy not only promotes operational efficiency but also establishes a solid groundwork for long-term enhancements in healthcare delivery, ultimately leading to better patient outcomes and satisfaction. Strengthening the collaboration between stakeholders will further amplify the impact of these initiatives in the healthcare sector.

Media

Media

Integrations Supported

RouteGenie

Integrations Supported

RouteGenie

API Availability

Has API

API Availability

Has API

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Company Facts

Organization Name

PwC

Date Founded

1998

Company Location

United Kingdom

Company Website

www.pwc.com/us/en/products/smart.html

Company Facts

Organization Name

Change Healthcare

Date Founded

2007

Company Location

United States

Company Website

www.changehealthcare.com/solutions/value-based-payments/healthqx

Categories and Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

Categories and Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

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