Imaging Utilization Management Technology Focuses on Creating Savings, Quality Improvements and Meeting PAMA Mandate
Imaging utilization management (UM) is generally slow and expensive under the traditional prior authorization process. The best and most cost-effective opportunity to address this problem is at the point of care. Introducing ImagingGuide. This artificial intelligence (AI)-backed tech offers guidance in the electronic health record (EHR) with highly targeted clinical decision support (CDS) that helps select the right imaging decision at the right time for both inpatient and outpatient care. With this technology, providers can reduce unnecessary imaging that offers little to no clinical benefit to patients, all while improving patient care outcomes and reducing costs. ImagingGuide is designed to document Appropriate Use Criteria (AUC) and satisfy the Protecting Access to Medicare Act of 2014 (PAMA) mandate requirements if a payment penalty goes into effect.
Improve Inpatient Reimbursement
Improve reimbursement based on diagnosis-related groups.
Improve Outpatient Imaging
Reduce care requests likely to be denied by health plans and benefits managers.
Meets Appropriate Use Criteria (AUC)/ PAMA Compliance
Embedded clinical decision support (CDS) tool designed to comply with Centers for Medicare and Medicaid Services (CMS) mandate as well as offer imaging utilization management benefits.
Features & Benefits
• Adjusts CDS guidance based on analytics to help target the most impactful ordering situations.
• Uses natural language processing (NLP) to read data and help suppress nuisance alerts.
• Understands provider ordering patterns via machine learning (ML) to display the highest impact CDS only, and more.
Order Re-Evaluation After Note Completion
• Reassessment of rules after the point-of-order entry and alerting to help understand what providers document after interacting with the Stanson app.
• Designed to provide increasingly meaningful CDS from what is learned on re-evaluation.
Provider Feedback When it Counts
Provider-centric, peer-comparison feedback in decision support designed to enable providers to understand and compare their performance.
Expanded Guidelines for All Imaging Areas
Offers a growing CDS library of imaging UM alerts for all imaging areas and settings (AMB, IP, ED), not just the Priority Clinical Areas. Supports savings and quality improvements identified by literature and real-world insights in provider and payer organizations.
Utilization and Savings Trend Dashboards
Designed to enable governance by displaying trending utilization, outlier and savings metrics.
Expandable Imaging Technology
ImagingGuide is foundational tech that can be used in combination with Stanson’s AuthAssist and ImagingAssure solutions, which are technologies supporting electronic submission and expedited prior authorization (PA) reviews.
We knew the architecture of their PAMA solution, and it was designed to be minimalist as it pertained to acquiring data from the user. We thought it was a major advantage for us.
Dr. Mark Binstock, MD, MPH
Chief Medical Information Officer, Bon Secours Mercy Health
How Payers and Providers Can Simplify the Prior Authorization Process with PINC AI™ Stanson Technology
The PINC AI™ Stanson PA solutions use machine learning (ML), and clinician codified and validated PA policies to automate the manual process, which can reduce the wait time from days to less than a minute.
Less Interruptive, More Intuitive
How AI can help you meet the Appropriate Use Criteria (AUC) with the Protecting Access to Medicare Act (PAMA) solution and execute automated prior authorizations.
Prepping for PAMA at Intermountain Healthcare
At the beginning of next year, the Centers for Medicare & Medicaid Services (CMS) will require providers and practitioners become compliant with the Protecting Access to Medicare Act (PAMA) to ensure high-quality patient care.
Keep Calm and PAMA On
A providers’ guide for transitioning to a smart clinical decision support solution that meets Appropriate Use Criteria (AUC)
Health System Shares PAMA Implementation
A large, multi-state health system was challenged with choosing a solution to achieve the Protecting Access to Medicare Act of 2014 (PAMA) compliance, which requires that all advanced imaging services meet the appropriate use criteria (AUC) with a fully qualified Clinical Decision Support Mechanism (CDSM) to comply with the mandate.
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Frustrated With Your Current PAMA Solution?
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