Problem
Care coordination and patient navigation are critical frameworks within modern healthcare systems, designed to streamline the management of patient care across various settings and services. These methodologies are particularly crucial for patients with complex health needs, such as those with chronic conditions or multiple healthcare requirements. The 2024 updates to HCPCS codes reflect a growing recognition by the Centers for Medicare and Medicaid Services (CMS) of the need for formalized care coordination structures, ensuring that patients receive comprehensive and continuous care.
Our Solution
Rely Health offers a cost-effective, scalable technology solution that restructures your existing case coordination and transitions of care operations to meet new billing standards. Rely Health collaborates with your operations, case management, and billing teams to capture claims for these services and set up a real-time dashboard for leaders and administrators to monitor the health of your comprehensive navigation program.
In addition to enhancing your existing team’s capabilities, we provide two types of support programs to ensure robust patient engagement and care coordination:
- Virtual “Back Office” Navigation Hub: A team of virtual patient care navigators proactively engages patients after discharge, fostering strong patient relationships and improving overall satisfaction. This approach enhances lifetime value by ensuring continuous high-quality care.
- Dedicated “On-Site” Navigation: Additional on-site capacity (FTEs) supports the highest-risk populations, ensuring consistent delivery of care to patients who may otherwise not be seen again after a particular encounter.
The Rely Health Solution
- Care Navigation Training: Comprehensive training for your navigation and billing teams on the Patient Relationship Manager (PRM) and new workflows necessary to justify billing claims. This ensures proficiency and compliance, ensuring successful billing for care coordination / navigation work.
- Enhanced Reporting & Demographics Tracking: Our web-based PRM, integrated with your EHR data, automates demographic data collection and generates customized reports for administrative needs. This improves data accuracy and provides valuable real-time insights for better decision-making and compliance.
- Enhanced Reporting & Demographics Tracking: Our web-based PRM, integrated with your EHR data, automates demographic data collection and generates customized reports for administrative needs. This improves data accuracy and provides valuable real-time insights for better decision-making and compliance.
- Longitudinal Follow-up: Our infrastructure supports the creation and adaptation of workflows that automatically engage patients well after their visit through a hybrid AI and live patient care navigator model. This ensures long-term sustainability and adaptability to the hospital's needs.
- No-Lift Coverage: We manage the populations you cannot, scaling to cover every member of your daily census. Our virtual team engages with patients via their preferred contact method.
- Personalized Workflows: Each patient receives personalized SMS, email journeys, and phone calls based on their next best step in their healthcare journey. This approach emphasizes patient retention and appropriate placement.
Program Benefits
Implementing the Rely Health Navigation Hub optimizes patient interactions by freeing up your care management/transitional care team’s time by nearly 75%, allowing more one-on-one interaction with high-acuity patients and expanding longitudinal care pathways. Our virtual program ensures comprehensive follow-up for all patients, driving new patient acquisition and retention. It also improves hospital utilization rates by directing patients to appropriate PCP, outpatient, or community resources.
- Turn-Key Service: No overhead performance management or technology lift required. We design, deploy, and iterate until you reach your navigation goals.
- Dashboards & Analytics: Monthly charts for leadership demonstrating real-time health metrics.
- AI-Driven Scale: We achieve 10-15x more scale than in-house resources, ensuring comprehensive follow-up and engagement for every patient.
Summary
Rely Health’s comprehensive approach not only restructures your existing workflows to enable care coordination and navigation billing but also provides visibility into these processes for leadership. Our support programs, both virtual and on-site, ensure that every patient receives high-quality, personalized care. By partnering with Rely Health, your organization can achieve enhanced patient outcomes, improved operational efficiency, and significant scalability, setting a new standard in value-based care delivery.
Contact Rely Health to optimize your Care Navigation.
