Medicaid Consulting

Zane Networks is a leader in healthcare transformation services and solutions

Zane Networks’ experts work with state and district agencies and managed care organizations to address how health information technology can increase the efficiency of Medicaid processes and achieve better outcomes for patients.

We help clients respond to new regulations by providing insight on how best to improve their existing systems and explore emerging new, innovative approaches to respond to changing requirements. We aim to assist agencies and managed care organizations to optimize existing funding and reduce costs.

Our team has expertise in the following areas including:

Capabilities

  • Medicaid Optimization Projects
  • Coordination of Benefits Planning
  • HL7 FHIR Integration
  • Health Information Exchange Initiatives
  • Electronic Health Record Implementation
  • Medicaid Enterprise Systems Consulting
  • Third-Party Liability Solutions
  • Coordination of Benefits Solutions

Coordination of Benefits:

Zane Networks improves payment integrity and streamlines the coordination of benefits (COB) processes for Medicaid and managed care plans. Through our industry partnerships, we are helping payers to identify primary and secondary healthcare coverage before claims are paid – increasing payment accuracy while reducing the administrative costs associated with recovery. In addition to our consulting work, we have developed COB Insight, an application that has integrated with national claims databases to allow for the identification of primary and secondary healthcare coverage before claims are paid – increasing payment accuracy while reducing the administrative costs associated with recovery.

System Integration and Interoperability

We work with clients to help their systems comply with industry standards, leveraging HL7 FHIR as a data standard to facilitate the meaningful exchange of health data. To ensure interoperability, we assist in the use of standards to share data across disparate healthcare settings regardless of the application and vendor. Our experts stay abreast of HL7 FHIR standards as members of the ONC HL7 workgroups. Zane Networks has more than 10 years of experience working directly with local and regional HIEs and have worked on projects with Medicaid agencies and HIEs to improve how healthcare organizations share data to improve health outcomes.

Health Information Technology

Our company has over 15 years of experience in implementing Electronic Health Records and promoting the use of health information exchange under district and state initiatives. Zane Networks has worked under Medicaid-funded programs to expand the use of these health technologies to encourage the adoption of meaningful use of electronic health records and HIE connection to help agencies meet their state and district goals to reduce healthcare costs and improve care.

Our team also brings independent experts to ensure that state and district Medicaid Enterprise Systems (MES) meet government requirements and institute optimal business processes when implementing MES modules. Our team works with clients to ensure that they consider both the financial and strategic considerations and risks associated with MES implementation.

Sample Clients & Projects

Crisp