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

FHIR Engine, Inc

Transforming Utilization Management

Brainstorm Team Meeting

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.

Confident Businesswoman_edited.jpg

Our Solutions

Transforming Utilization Management

  1. Supporting Payers, Providers and Consumers in Treatment Decision Support and Utilization Management

  2. Covering Inpatient Level of Care, Outpatient Prior Authorization, Pharmacy Scripts and Ancillary Services using AI scoring to recommend the best decision 

  3. Using NLP/AI techniques to enable coding clinical and administrative content into digitized Decision Treatment Questions using our Machine Learning NLP Digitization Engine

  4. Automating the complex task of Payer policy and business rule coding using our Utilization Management Change Management Engine

  5. 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

  6. Capturing real-time execution data against configuration packages to enable Utilization Management Analytics Dashboard

  7. 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

Business Team

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.

Collaborating at Work

"The best way to predict the future is to create it"

Abraham Lincoln

Get in Touch

We’re happy to hear from you. Contact us today to learn more about our business and how you can benefit from working with us.

Thank you

One Boston Place

Suite 2600

Boston, MA 02108

Thanks for submitting!

Collaborating at Work