bServed for Health Plans and IPA's

The crucial role Health Plans and Independent Physician Associations play in effective patient care cannot be overstated. At bServed our full-service Utilization Management Program is designed to benefit Health Plans through our proven review process. We make sure all patients are treated on their appropriate level of care and with DRG valuation.

We also provide care coordination with follow up for their insured patients. Consequently, we help decrease Health Plans costs. In care coordination we follow high risk patients and eliminate unnecessary readmissions resulting in fewer hospitalizations. We coordinate those cases and keep patients healthy.

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bServed’s UM system
for Health Plans & IPA's

bServed’s UM system for Health Plans & IPA's advances and facilitates the best patient outcomes, which are always coupled with the dual goal of cost savings.

With care coordination, patient engagement, and transition care models. bServed’s systematic, efficient, and cost-effective program will simplify Case Managers’ responsibilities and ensure lower costs overall.

bServed’s ensure lower costs overall.

bServed’s systematic, efficient, and cost-effective program will simplify Case Managers’ responsibilities and ensure lower costs overall.

We help reduce such events as avoidable delays/days

Through transition care we help reduce such events as avoidable delays/days, and focus on continual communication with physicians, clinicians, and insurers.

We tailor a system to fit your company’s needs.

We tailor a system specifically designed to fit your company’s needs. You will never be subjected to a “cookie-cutter” approach.

Challenges range from

Several challenges confound administrators of Health Plans & IPA's. Insurers are facing mounting difficulties in maintaining a company’s financial health, and safeguarding ROI. When 10% or more is spent on care management programs, the financial benefits can be precarious.

Inadequate personnel

Inadequate personnel to process increasing prior authorization requests.

bServed provides monthly reports

Additional clarification, if needed, is sought from consulting or attending physicians, and bServed provides monthly reports on financial effectiveness using such tools as analytics per physician.

bServed provides physician education

bServed provides physician education on Clinical Documentation Improvement, working with hospital leadership, such as the Chief Medical Officer.

Proficient in InterQual and MCG Guidelines

Our managers are proficient in InterQual and MCG Guidelines and can produce cost savings while delivering high-quality care. In support of the course of treatment, all proper documentation adheres to a strategy designed to reduce claims.

Results bServed delivers to Health Plans & IPA's

bServed’s advantages give insurers the tools to achieve financial goals and best patient outcomes

Clinically appropriate site-of-care choice.
Appropriate level of care for the patient’s condition.

Hospital medical records audits ensuring accurate coding of diagnoses.
Assuring use of in-network providers.

Through Transition Care, we

Identify patients with post-acute needs, such as those at risk for readmission.
Prioritize, and even intervene as necessary.
Evaluate readmitted patients to identify and implement strategies for improvement.

For Patient Engagement, we

Use improved data sets to identify more potential members.
Follow Consumer engagement trends, including micro-targeting.
Utilize patient family engagement.
Enhance member contact information and leverage multiple channels to reach members.

For Avoidable Delays/Days, we:

Utilize a validated system/defined methodology to track avoidable delays/days.
Prioritize, and even intervene as necessary.
Evaluate readmitted patients to identify and implement strategies for improvement.

For Denials/Appeals, we

Proactively initiate claims denials when:
Inappropriate level of patient care was utilized.
Treatment was not medically necessary.
Inappropriate diagnoses were coded.

Our Sevices

Why bServed is your best choice

Utilization Management

Leave the burden of Medical Necessity Reviews and Utilization Management to us. bServed’s care monitoring system improves the use of resources and the quality of care when our highly skilled and trained teams assume time-consuming Case Managers’ tasks.

Clinical Documentation Improvement

Hospitals that implemented bServed’s Clinical Documentation Improvement program see, on average, a $4 million annual additional reimbursement per 100 average daily patient census.

Denials Management

Never again write off denied revenues. Our Claims Denial Management solutions improve patient care across the board while helping bring down operating costs.

Transitional Care Management

Just 24 hours from discharge, our highly trained clinical staff assess and assist patients with a smooth transition back to the community, ensuring their health and safety. As a result, the contracted hospitals experience immediate decreases in 30-days readmission rates and improved patient satisfaction.

Remote Patient Monitoring

At no cost to the clients or patients this portion of our service, utilizing an RPM device, gives Hospital and Primary Care Physicians a 24/7 real-time view of patients’ health. bServed strives to work seamlessly with our clients.

Experienced
team About us

As a physician and experienced Medical Director my years’ experience in HMO, Hospitalists, and Acute Care have given me a unique perspective on the challenges hospitals face today.

A graduate degree from the Marshall School of Business in Medical Management helps me evaluate how a hospitals’ financial health can lead to improved patient health. Dual goals accomplished in harmony.

Working with bServed allows me to apply my knowledge toward improving efficiency and value for our participating hospital partners.

Our foremost goal is your company’s success. Argo Babakhanyan MSN, RN, PHN Chief Operational Officer

Our cases

Case 1 Case 2 Case 3

Culver City Hospital, Acute Care HospitalSouthern California

43% drop in the hospital’s denials 1 day decrease in the average length of stay

Home to the Southern California Hospital Heart Institute, this Acute Care Hospital serving West Los Angeles provides 24-hour medical service and expanded from 82 beds to the current 420.

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Taylor Regional Hospital (TRH), in CampbellsvilleKentucky

30% increase in admission rate 40% drop in payor denials

A 90-bed facility which includes services from an ED to obstetrics, orthopedics, and cancer treatment.

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Eastland Memorial HospitalTexas

36% denials by payors decreased 23% hospital readmissions decreased

Eastland Memorial Hospital, located in the county seat of Eastland, Texas, is the only hospital servicing the more than 18,000 area residents. The hospital provides a variety of care including acute care, a cardiac rehabilitation center, surgical and medical services, specialty clinics, and a Level IV Trauma Center Emergency Department.

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Team bServed

bServed. For maximum efficiency,
better patient care, more cost savings.

Chief Nursing Officer Argo Babakhanyan, MSN, RN, PHN

Argo has worked in all facets of nursing, from home health to Cardiothoracic ICU Nurse, and his 10-year background experience in health care includes management expertise in such diverse programs as patients' throughput, value-based programs, and Readmission Reduction.

Chief Operating Officer Edwin Leon, MSIHCM, RN

Who we work with

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Hospitals

Utilizing data capture, denial analysis and reporting, bServed directly addresses the reasons for rejections, providing the tools to quickly pinpoint problems, and take corrective action. bServed successfully appeals Medical Necessity and DRG Validation payers’ denials.

Health Plans and Independent Physician Associations

Working with bServed, Health Plans and Independent Physician Associations fortify their relationship with their associated hospitals and physicians, increasing leverage and efficiency.

bServed helps them cut costs by more efficiently processing their clients’ Medical Necessity Reviews, Admission Notifications, DRG Validation, and Prior Authorizations. As a complete service option, bServed offers peer-to-peer calls with attending physicians, as well as peer-to-peer calls with payers and the medical directors. Turnaround time is efficient. And ROI is vastly improved. The company runs more effectively, the patients see improved processing of their health insurance claims, and overall costs are lowered.