Tele Med Solutions To Injury Care Management
About Us
A New Approach
A New Approach
Medquest Resolutions LLC, an Industry Leader in Injury Data Analysis and AI Systems Applications is now making available the full scope of its Clinical Treatment Pathways as a Resource and at a level of usage structured to the needs and requirements of its subscriber clients fully facilitated to the Tele Health Environment
A New Approach
A New Approach
A New Approach
Explanation: Artificial Intelligence v. Expert Systems
The simplest way to explain the difference between AI and Expert Systems is to understand that an expert system uses already existing knowledge to make decisions while artificial intelligence uses already existing data to make decisions. For example, with an expert system, a collect
Explanation: Artificial Intelligence v. Expert Systems
The simplest way to explain the difference between AI and Expert Systems is to understand that an expert system uses already existing knowledge to make decisions while artificial intelligence uses already existing data to make decisions. For example, with an expert system, a collection of best practices and expected outcomes are entered. This makes up the knowledge base on which decisions as to the best course of medical treatments and expected outcomes, including patient wellbeing and costs are estimated. Treatment courses can be recommended. An expert system can be updated when new data is available, such as new treatment modalities or treatment combinations, which lead to better outcomes (which are those defined by the user, and could range from total cost and patient satisfaction, to profit margin to the insurance company).
Artificial intelligence works in a completely different way. Best practices and expected outcomes are not entered. The AI system is given all the data to be analyzed, including the treatment plans, costs, patient satisfaction and profit margins. Then the system is given one additional input i.e., to determine whether the outcome for each specific case is satisfactory or unsatisfactory. If the database is large enough, the AI system will determine “which” are the best practices and “what” the desired outcomes will be. This is the fundamental task of an AI system.
At Medquest we fully exploit all aspects of both AI and Expert Systems to achieve the best outcomes for our clients.
Medquest Resolutions LLC
11 Mt. Pleasant Ave.
Dover, NJ 07801
Cell Phone 973-452-9089
www.medquestresolutions.com
©copyright 2022
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Our Services
As a service organization to the insurance claims industry, Medquest Resolutions LLC, was established to create and provide software which would allow full integration of activities between the many participants in the management of insurance claims with medical components, i.e. from medical providers to insurance adjusters, nurse case managers to rehabilitation specialists, safety & loss control personnel to financial analysts, and claimants to employers. Medquest Resolutions’ technology provides a manifold approach through use of the internet to connect all the diverse parties with information flowing quickly and securely amongst all users. It allows for medical providers (physician, therapists, etc) to submit medical bills and reports “on-line” thereby substantially reducing their Medical Practice Overhead Costs while providing quick & easy communication amongst all parties resulting in greater accountability at all levels. It fosters greater organizational efficiency thereby generating greater cost savings to all parties while delivering better patient care by reducing costly treatment delays. It provides better medical treatment outcomes for patients through qualitative analysis of best medical practices data through the use of artificial intelligence applications. This integration and analysis is a “first” to the insurance claims industry.
Industry Trends
Recent trends in the insurance service industry have led to greater integration of services. Bellwether insurance carriers have acquired Third Party Claims Administrators (TPAs), Rehabilitation Providers, Managed Care Organizations (MCOs), and Preferred Provider Organizations (PPOs). This integration of single services organizations has failed to produce the anticipated progress in the quality and efficiency of care, due to an adherence to a fixed, rigid and unchanging application of "antiquated management methods and practices", in essence, expanding the traditionally flawed claims processing paradigm to new levels. In out pacing the industry push for availability of services, the Medquest team created a new model of engagement, offered as a software-as-a-service (SaaS) product suite. Dynamic in its database's analytical capabilities, embracing "best practices" methodology, and effectively incorporating managed care with the best in claims processing, the Medquest team has focused effective care and cost containment into a tight-knitted agreement. To do this, though, doctors and hospitals need instant access to data about patients - diagnoses, medications, test results, procedures and potential gaps in care that need to be addressed. As long as this information was stuffed into manila folders in doctors' offices and hospitals, and not turned into electronic records, it was difficult to execute these kinds of analyses. That is changing.
We at Medquest are confident that our go-to-market readiness is perfectly timed. With the advent of newly formed Accountable Care Organizations (ACOs), forward-thinking organizations are seeking to survive and thrive by improving efficiency; focusing on best practices in all areas from medical interventions to care management, with increased provider and patient engagement; and integrating rather than competing with outpatient providers. Additional key strategies include adoption of EMR and unified data repositories to improve administrative efficiency and minimized duplication of services and utilization of information technology to engage patients at home. In a recent New York Times article by Thomas L. Friedman, Friedman speaks of "a new marketplace and platform for innovation - a health care Silicon Valley - that has the potential to create better outcomes at lower costs by changing how health data are stored, shared and mined. It's a new industry." Medquest has not only fulfilled, but has surpassed, this vision entirely in the field of Worker's Compensation. In bringing together the best "innovative thinking" in medical claim management, Medquest has architectured a unique methodology, whereby all aspects of medical management are provided through a single organization, resulting in extensive medical treatment cost savings and better patient care that can be passed on to our clients. Finally, in full culmination of the Medquest team's thought-leadership, we have capitalized on our software's intelligent capabilities to analyze "loss data", and thus, to "predict" future cost trends. In so doing, we firmly believe that our Global Fees for Episodes of Care application module, designed for Worker's Compensation Flat Fee enabling, is positioned, once again, to change the game in Worker's Compensation and group health medical care, and claims management.
Adaptability
A unique aspect of our AI software Adaptation "ISI" (Intuitive Synthetic Intelligence) is that it is continuously updated based on input form manifold sources. Comparisons are constantly being made and conclusions constantly being drawn from data received from medical care practitioners, medical panel experts, and rehabilitation advisers. Thus, the user of this system has available: 1. the current injury diagnosis, 2. any intervening medical impacting factors based on a wider frame of reference, 3. the current treatment plan, 4. potential alternative treatment plans, 5.predicted outcomes and, 6. projected treatment costs for all treatment plans based on the current diagnoses and any intervening medical impacting factors, coupled with the
treating physician's past performance record.
Our Committment
To provide client accounts with a value added product which will increase their profitability.
• To assure that medical practitioners will provide the best medical care in a comprehensive, concise and expert
fashion through a mechanism which rewards prompt effective care and eliminates ineffective, protracted care.
• To provide the client account with meaningful workers' compensation and group health cost containment by reducing redundant,
ineffective care and unnecessary lost work time and excessive administrative service fees.
• To exercise and maintain control over all aspects of the medical care experience through the integration
of all medical management processes through the use of advanced software and best available medical providers..
Communications
Medquest connects health care providers, insurance companies, and administrators in a comprehensive site. Costs are clear and upfront, and payments proceed without delay. Providers can immediately view previous reports for a claim, administrators can monitor progress, and carriers can analyze costs. It was initially designed to streamline the payment process through pre-negotiated pricing. It has however grown into a comprehensive program where providers, carriers, panel physicians, and health care administrators can view and analyze whatever data they need. This is unprecedented in the health care industry.
We encourage your inquiries
We believe that through clear communications and the application of state-of-the-art technology and concise methodologies we can provide your company with the best tools to attain your business objectives.
We encourage you to contact us with any questions.
Contact us at 973-452-9089