Abstract luminous DNA molecule. Doctor using tablet and check with analysis chromosome DNA genetic o

FHIR Engine, Inc

Transforming Utilization Management

Our Mission

Our mission is to lead the industry in Interoperable, AI-driven Treatment Decision Support Solutions using DaVinci standards and value-based use cases. We digitize payer policies to manage evidenced-based care for patients leveraging HL7 FHIR standards enabling real-time, dynamic point of care interaction between payers, providers, and consumers versus traditional batch-oriented EDI.

Our Solutions

Transforming Utilization Management

Supporting Payers, Providers and Consumers in Treatment Decision Support and Utilization Management
Covering Inpatient Level of Care, Outpatient Prior Authorization, Pharmacy Scripts and Ancillary Services using AI scoring to recommend the best decision
Using NLP/AI techniques to enable coding clinical and administrative content into digitized Decision Treatment Questions using our Machine Learning NLP Digitization Engine
Automating the complex task of Payer policy and business rule coding using our Utilization Management Change Management Engine
Supporting consumer plan benefit coverage (vs. member eligibility), pricing transparency, cancer treatment protocols, lab registries, DME registries, rad/card and site of service using our Modular Cost & Transparency Tools
Capturing real-time execution data against configuration packages to enable Utilization Management Analytics Dashboard
Allowing rapid API processing of at-scale UM transactions with a FHIR enabled Utilization Management Transaction Engine

Benefits

Improved Timeliness of Care, Improved Quality of Care with evidenced-based Treatment, Lower Medical Costs, Lower Administrative Burden & Costs, Higher Transaction Adjudication, and Lower Cost of System Ownership

What We Do

At FHIR Engine Inc, we believe that our solutions will soon become one of the transformational changes in the healthcare industry for treatment decision support and interoperability.

We’ve only just started, but we already know that every product we build will deliver innovational value to providers, payers and consumers.

Please e-mail or call for a Demonstration our of products.