MediSKY's Radiology Accountability Solution™

Key Benefits

  • Real-time health plan access to all patient radiology imaging
    • Enabling real-time Quality Assurance and Medical Necessity reviews
  • Centralized database of health plan patient radiology metadata
    • Augmenting preauth process to preemptively prevent duplication 
  • Real-time integration of MediSKY imaging database to health plan claims data
  • Fraud and abuse prevention via MediSKY Alert System
  • Cloud-based deployment of radiology viewing software to in-network health care providers
    • Accessible from Windows, Mac, Linux, iOS (iPhone/iPad) and Android
    • Enables simplified and secure imaging transfer between health plan in-network radiologists
  • Secure storage of all health plan patient radiology in redundant Enterprise-Level, HIPAA-compliant data centers 

MediSKY's Radiology Accountability Solution™

The Problem

Let’s put this simply: For decades, when it’s come to radiology, health insurance companies haven’t gotten what they were paying for – literally. That is, insurance companies have never received a copy of the actual imaging they paid for.

Yes, health plans receive claims submissions and pre-authorization requests for radiology. But imagine if a health plan had access to all of their patients’ imaging, delivered in real-time before its patient’s feet even hit the floor? 

Imagine the fraudulent claims for imaging never taken that could be virtually eliminated. Imagine the claims for redundant and duplicate imaging that could be stopped at the pre-authorization stage, because you knew that clinically appropriate prior imaging had been taken only days before. Imagine being able to deploy that imaging in diagnostic quality for a legitimate second opinion, but without having to pay a claim for a second imaging procedure. Imagine real-time Quality Assurance, to ensure that you aren’t being double-billed for a poor-quality image. Imagine the empowerment to do Medical Necessity reviews like never before.

This all sounds great, but this idea poses its own set of problems:

Introducing MediSKY's Radiology Accountability Solution™

Leveraging a suite of first-of-its-kind technologies and a cutting-edge cloud-based platform, MediSKY's Radiology Accountability Solution is bringing Accountability to Radiology.  Our revolutionary solution gives health plans, ACOs, and RBMs access to all of their patients’ radiology imaging in real-time, before their patients' feet even hit the floor.

Fraudulent claims for imaging never taken - virtually eliminated. Claims for redundant and duplicate imaging - stopped at the pre-authorization stage. Prior imaging securely deployed for a second opinion - without paying a claim for a second imaging procedure. Real-time Quality Assurance - a reality.  Medical Necessity reviews - empowered like never before.

Of course, we've solved all the technical problems.  Our suite of proprietary technologies is powered by an enterprise-level, HIPAA-compliant, kernel-based cloud computing platform spanning multiple secure data centers, designed by a former CIO to multiple HMOs and consultant to the Centers for Medicare & Medicaid Services.

Our Radiology Accountability Solution serves as a central­ized repos­itory for all of a health plans' patients' radi­ology imaging, provid­ing each patient with a unified radiology record reaching across all health­care pro­viders.  Our solution also assembles a massive relational database of patient imaging, underlying metadata and claims data, all of which is made available to health plan personnel and analyzed by our proprietary suite of algorithms.  By analyzing the health plan's claims data, MediSKY matchs each radiology claim to its corresponding imaging, automatically flagging fraudulent claims and notifying health plan claims personnel.

Radiology viewing is revolutionized as well. For the first time, health plans, radiologists, and referring physicians will all have access to remotely-deployed diagnostic-quality imaging, available instantly, without downloading large files or waiting on archaic CD delivery.

MediSKY Technologies' Radiology Accountability Solution is compatible with every major PACS system on the market today, meaning that without any additional software and hardware, MediSKY can be rolled out to your health plans' in-network radiology clinics with minimal effort.  After setup, all of a radiology clinic's imaging for a MediSKY customer health plan or ACO will be directed securely to our enterprise-level, HIPAA-compliant set of data centers.

Start using MediSKY's Radiology Accountability Solution today

MediSKY Technologies is here to help you save a significant amount of money. We can start integrating you into our revolutionary system within a matter of days, making your savings nearly instantaneous. Contact us today and learn how we're here to bring Accountability to Radiology.

Return to Homepage