Through appropriate data collection, mining, and analysis; Nano Health has developed extensive expertise in data analysis and reporting. The company has also partnered with a number of leading organizations to support in delivering our clients with quality healthcare data analysis, while maintaining the protection of patient privacy and data confidentiality.
Nano Health realizes that the transformation of the healthcare industry in the region is accompanied with challenges at the level of healthcare providers, payers, and regulators. Therefore, we have designed consultancy service packages that address technical, coding, operational, and policy making needs of our clients.
Nano Health provides training services as a main component for most of its solution offerings. Our trainers are team members that have been engaged in the design, development, testing of our systems, and are actual system users on almost daily basis.
Nano Health solutions can be deployed and operated as stand-alone solutions or as loosely coupled platform solutions communicating standard common language. HealthConnect is the flagship comprehensive platform coupling all of Nano Health solutions.
Health Insurance Community Portal Health Insurance Product Marketplace Transactions Post Office Payer Transaction Manager Provider Transaction Manager Dashboards & Analytics Checks for Drugs and Services Adjudication Insurance Management System Insurance Registries e-Prescribing Solutions Pharmacy Benefit Manager (PBM) Health Insurance Data Dictionary Drug Databases & Registries Pharmacy Management System Clinic Management System Provider Insurance Scrubber Computer Assisting Coding System
Commonly Coupled Solutions:
Payer eRx & Pharmacy Benefit Management Platform Payer Insurance Management Solution Health Insurance Community Platform Regulator E-Prescribing Platform Pharmacy Enterprise Solution Clinical Enterprise Solution Scrubber Enterprise Solution .
The solution also provides a registration and access control managed gateway for various connecting health insurance platform solutions such as applications, data dictionaries, and analytics. Moreover, the solution has medical profilers for healthcare facilities, its departments, and associated doctors, and covered plans/products at their facilities.
In addition, the solution profiles the payers (Insurance Companies and Third Party Administrators) for its offered healthcare insurance products and its networks.
It includes generating and managing the following transactions: Remittance Advice, Eligibility Response, Authorization Response, Message Post. The solution enables receiving and parsing the following transactions: Claim Submission, Eligibility Request, Authorization Request, Prescription Request, and Message Download.
It includes generating, managing and submitting the following transactions: Claim Submission, Eligibility Request, Authorization Request, Prescription Request, Referral Post, Message Post. The solution enables receiving and parsing the following transactions: Remittance Advice, Eligibility Response, Authorization Response, Prescription Response, Referral Download, and Message Download.
Monitors for quality indicators, potential fraud, waste & abuse are the focus of these analytics and dashboards. It covers indicators for efficiency, clinical outcomes and patient experience. These monitors are offered through Nano Health’ existing built solutions such as Nano bI.
NANO MED Medical Coding Edits: A decision support system developed by Nano Health that enables industry stakeholders to check and alert on potential mistakes and reviews in medical coding. The solution provides more than 16+ Million Edit Combination Checks grouped into Medical Necessity/Cross Coding Checks ICD10AM – CPT, ICD10AM – HCPCS, ICD10AM – CDT ICD10CM – CPT, ICD10CM – HCPCS, ICD10CM – CDT ICD9CM – CPT, ICD9CM – HCPCS, ICD9CM – CDT ICD9CM mapping to ICD10CM ICD10CM mapping to ICD10AM , as well as Coding Checks. The solution also manages edits for bundling, mutually exclusive coding, duplication, maximum allowed frequencies, services relationship errors, encounter related edits. The system is totally independent and based on guidelines from recognized bodies such as CMS, AMA, ADA, local authorities, and other recognized societies. A decision support system for medical coding edits including millions of edits validating medical necessity, coding error and more.
Drug Administration & Control System: A decision support system to monitor drug safety and medical necessity (interactions, indications, contraindications and more). The system is built to cater to local settings including localized medications, prescribing trends, and commonly encountered safety issues pertaining to drug and medication dispensing.
- Quotations and online payment
- Claim processing
- Auto eClaim processing
- Approvals and call center
- Portals for providers, members, brokers, and clients
- Members mobile app
- Reinsurance management
- Bi – Analytics engine tools
- Human Resources, time attendance, and payroll management Modules
The process of updating the above registries is expected to be a transaction-based process. However, many Providers and Payers lack the necessary IT capability to develop systems to generate, update and manage through transactions. The registries would provide a user-friendly access interface to enable the generation and management for these registry transactions.
The following are the registries provided: Person Registry, Product Registry, Payer Registry, Provider Registry and Complain Registry.
Person Register transaction services shall enable the Payer from sending the insured members details. Product Register transaction services shall enable the Payer to register the healthcare insurance products that are being sold under its portfolio. Payer Register transaction services facilitate the registration of Payer related details as per the requirements. Provider Register transaction services facilitate the registration of Provider related details as per the requirements. Complain Registry is a system to capture health insurance stakeholders complains. The system coordinates and manages the requests (complains, suggestions, responses, messages) with a priority and escalation controlled mechanism.
With the simple straight forward screen doctors can practice adding new e-Prescription case by log into The NANO PBM e-Prescription portal and submit the patient case details, diagnosis and drugs then submit the requests, in case the patient was invalid or provider (doctors) out of network system will stop at that stage directly and alert doctors about it, for instant (system will say member is in active, or, card is not found, or you are out of network cannot treat this patient as direct billing ....).
- Submit new prior request
- Submit new prior request with e-RX (e-Prescription)
- Search historical requests, and export the data if needed
Submit claims (if not set by payer as auto submission enabled, if payer set auto submission the pharmacist cannot decide because
once they dispense the claim will be sent to the payer electronically via NANO HUB).
- Brows the dashboard.
e-PBM Switch: A Pharmacy Benefit Management transaction switch that connects provider solutions with payer solutions and the regulator's post office. The switch also runs a rule engine to validate transactions.
e-PBM Engine: A PBM engine to respond to ePrescriptions and pharmacy claims. PBM services are currently provided through Nano Health.
Drug Registry System: A system developed to manage an authority's drug registries. The system enters information, codes the information, and generates the drug codes for each drug based on the information entered. The system is managed through a privilege control and audit trail.
Drug Databases: A centralized structured drug database comprising of commercial and scientific details of drugs. Currently, it comprises of several countries’ drug databases, the system links the core drug codes to international decision support systems.
Modules: e-Prescription | e-Claims & Insurance Management | Pharmacy Benefit Management (PBM) | Point of Sale | Inventory Management | Drug Information | Patient Records | Financial Management | Basic Reports & Analytics | Rx Labels | Electronic Ordering for Chain Pharmacies | Admin Management | Add-Ons (Safety Checks, advanced Dashboards, and Analytics).
Modules: Registration and Admission | Dental Module | Appointment System | Outpatient Management | Laboratory Ordering | Radiology Ordering | Billing and Accounting | Medical Records | E-Prescriptions | Medical e-Authorizations | E-Claim Management | Basic Reports |Add-Ons (Dashboards, CEED, Drug Checks, Dashboards, and Analytics).
e-Prescribing Solutions | Pharmacy Benefit Manager | Dashboards & Analytics | Drug Databases & Registries
Adjudication Insurance Management System | Payer Transaction Manager | Code & Drug Checks | Dashboard & Analytics
Health Insurance Community Portal | Health Insurance Product Marketplace | Transaction Post Office | Payer Transaction Manager | Provider Transaction Manager | Dashboards & Analytics | Checks for Drugs and Services | Insurance Registries | e-Prescribing Solutions | Health Insurance Data Dictionary | Drug Databases & Registries
e-Prescribing Solutions | Transaction Post Office | Dashboards & Analytics | Insurance Data Dictionary | Drug Databases & Registries
Pharmacy Management System | Checks for Drugs and Services | Dashboards & Analytics
Clinic Management System | Checks for Drugs and Services | Dashboards & Analytics
Provider Insurance Scrubber | Checks for Drugs and Services | Dashboards & Analytics
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