Mphasis Eldorado, a division of Mphasis and a provider of enterprise core administrative platforms, has announced the extension of its long partnership with Change Healthcare to include the integration of its Javelina solution with Change Healthcare’s pre-payment insight and review services. These services were previously integrated with Mphasis Eldorado’s HEALTHpac solution, and the integration has now been extended to enable Javelina users to benefit from these services to help improve payment accuracy and prevent overpayments.
Reports from the Government Accountability Office show in excess of $144 billion in improper healthcare payments in fiscal 2016, up from $137 billion in 2015. The sheer size and scope of the problem is becoming more acute as healthcare payers and providers increasingly focus on managing costs.
“This partnership will bring Change Healthcare’s leading payment integrity solutions to Eldorado’s clients using Javelina, enabling them to realize efficiency, meaningful cost savings, and improved accuracy in their claim-payment processing,” said Kurt Anderson, Senior Vice President and General Manager of Payment Accuracy at Change Healthcare. “Change Healthcare offers a combination of expertise and sophisticated technology to combat improper payments by helping to detect and prevent incorrectly coded claims, drive payment accuracy, and protect the assets of payers and their customers.”
This new offering will support both companies’ joint customers by allowing post-adjudicated claims to flow seamlessly from Javelina to Change Healthcare, and will allow access to Change Healthcare’s Integrated Repricing Network and other out-of-network pricing services, pre-payment code edits, and pre-payment medical record review services. Based on the clients’ selection criteria, the claims will flow from Javelina to Change Healthcare for administration of the processes before returning to Javelina, where the claim will continue through the administration of benefits and claims payment process. Full reconciliation reporting is available. The solutions are available for client utilization now.
“This integration between Javelina and industry leader Change Healthcare is another example of Eldorado’s continuing quest to bring enhanced operational experiences to our customers,” said Sally Else, President at Mphasis Eldorado. “The ongoing objective to reduce the administrative costs associated with benefit management and claims processing will allow Eldorado customers to continue to be the most successful in the marketplace.”
For more information contact Pete Titas, Vice President of Sales, Payment Integrity at Change Healthcare.
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