Healthcare Solutions From CapB

CapB has a comprehensive presence in the healthcare industry across Business Optimization; Clinical Optimization; IT and Infrastructure Solutions and Management. Our Healthcare solutions include: |Payers |Providers| e-Health| Revenue Cycle Management|Predictive Analytics| Mobile Solutions| ICD-10 transition | Certification and Meaningful Use | Claims Management |Pharmacy Performance Management |Plan Performance Management | Disease/Wellness Management |Payment Innovation|

CapB’s comprehensive understanding of healthcare market, solutions including ISVs and their products guarantees a successful implementation and configuration of healthcare software solutions/products. Our implementation services range from business analysis, requirement gathering to user training aligned toward solution adoption.

CapB understands various interoperable standards such as HL7, DICOM, HIPAA, ICD, IHE, LOINC, SNOMED and NCPDP SCRIPT. Our Technical expertise also enables us to integrate your systems with other systems to ensure higher data convergence to ensure you have a complete view of patient’s data to provide the best care. We can help our customers achieve these standards with perfection. Our interoperability solutions are lined along consulting, developing and testing; maintenance and support; and training.

Health insurance business is undergoing dramatic changes such as addressing healthcare reforms and regulatory mandates in order to emerge as a more mature, agile and standardized industry. The payers are increasingly considering business transformation and new technology adoption to improve health outcome, sustain business growth and remain competitive, with the following initiatives:

Product standardization – Simplify benefits and reduce restrictions for customized product configuration

ICD10-5010 Conversion – Transition to new standards and meet compliance deadline

Health Insurance Exchange – Modernize online sales and service functions to prepare for more transparency and accessibility

Real-time Analytics – Develop robust business intelligence and analytics systems for internal and external decision making

Care Management – Improve quality and cost of care to offer more personalized services

Customer Experience Management – Improve customer’s interaction and satisfaction across service delivery, product and brand

CapB Healthcare vertical – Payer Practice with deep insights into the health insurance industry across the commercial and government segments, has designed the following solution offerings to meet payers’ business manifesto:

Legacy Modernization

Packaged Product Services and Benefit Configuration

Regulatory Compliance

Care Management

Enterprise Business Intelligence and Analytics

Sales and Consumer Self Service Web Portal

CRM Solution and Analytics

Payer Enterprise Testing

Healthcare Infrastructure Management and Hosting

Business Process Outsourcing..

Hospitals today are under severe pressure to improve the quality of care and reduce medical errors while ensuring compliance with stiff state and federal laws. With tight IT budgets and limited skilled resource pool, it is increasingly becoming a challenge to balance these requirements.

Current challenges for healthcare provider organizations are:

To automate the care processes, i.e. to implement EMR within the four walls of the healthcare provider whether it is a hospital, a physician practice, a laboratory or all media extending to home health

To begin to connect the individual in healthcare – providers and care seekers

To digitize healthcare – structure and store healthcare data in a way which creates knowledge

To take that knowledge and begin to drive that back into improving clinical and financial outcomes

Patient Centered Medical Home (PCMH), Accountable Care Organization, and Bundled payments—each of these reimbursement models requires the measurement of physician performance and the active engagement of physicians to monitor and drive improvements in results. Implementing new reimbursement and care delivery models cost-effectively and scaling programs across large numbers of physicians requires proven integrated and automated provider engagement tools.

CapB Provider Performance offerings allow health plans to:

Develop networks that are based on providers offering the greatest efficiency and quality

Proactively manage providers—identifying high and low performers; provide best practices for improvement

Give providers actionable information to improve patient management; deliver aggregated care alerts and patient registries

Manage referrals; measure and benchmark specialty providers

Gain insight into provider and hospital practice patterns

Manage multiple reimbursement programs concurrently

Quickly create customized measures that align with your cost drivers

Automating provider reimbursement and measurement process lowers administrative costs while effectively engaging providers in your program.

How CapB Helps

From clinical consulting, to implementations, to clinical outsourcing, our efforts are focused towards enabling our partner healthcare provider organizations to improve patient safety, deploy transforming technologies, and save you money to fund new investments for enhancing health delivery…

CapB is a leader in Predictive analytics and modeling across verticals. We have listed below some areas ( not a comprehensive) where our Technical and domain experts can help you.

Simulate PRO (Patient Reported Outcomes) for care quality improvement and outcomes.

Accelerate time to market for new therapies with strategic portfolio modeling.

Predict market access and optimize resource allocation for new therapies.

Predict high risk patients for ACO (accountable care organization) and hospitals.

Leverage advanced analytics to reduce hospital readmissions.

Simulate connected health consumer and recommend technology interventions that drive healthy behavior change.

Simulate the financial risks and incentives of emerging reimbursement models for ACO.

Quantify health costs & productivity of simulated workforce while recommending the most appropriate wellness intervention

Within CapB, data modeling and algorithm development is performed using industry leading tools for data mining and supervised machine learning such as Weka, Orange, and R. Ongoing efforts include classification models for a generalized predictor of hospital readmissions, heart failure, length of stay and clustering of patient outcomes to historical cohorts at time of admit. Most importantly, we use training data in addressing the predictive analytics demands of clients and site customization. So when your request comes – whether it involves classification or clustering or feature selection – CapB has the tools and the data and the expertise to successfully deliver top performing predictive analytics..

We offer a portfolio of strategic management services, revenue cycle solutions and advanced technology to help our clients achieve better business health. From keeping track of claims in the system, making sure payments are collected and addressing denied claims, our solutions on RCM maximizes your billing and collection performance. We offer extended business office solutions to address the challenges that today’s hospitals face…

CapB’s experience of working with various providers, payers, revenue cycle management companies and third party administrators has enabled us to comprehensively understand their systems and process. Leveraging our experience and understanding, CapB can provide claims management services across consulting, technology, and operations…

Our years of experience, working in the U.S. healthcare space has enabled us to understand ICD-9 and ICD-10 codes sets and its structure, build frameworks, ICD 10 impact analysis tools, and test scripts. Our ICD-9 and ICD-10 expertise has enabled us to provide ICD-10 transition services to payers lined along consulting and impact assessment services; remediation, planning and assessment; ICD-10 testing services….

The increasing need for mobile solutions across payers, providers, healthcare ISVs, revenue cycle management companies and third party administrators, has led us to develop mobile applications for Electronic Medical Records vendors. Leveraging the experience, CapB provides mobile solutions for entities across healthcare…..

CapB provides comprehensive pharmacy management solutions that enable you to measure pharmacy spend, utilization, and outcomes, and to provide patient level information to physicians and pharmacists that drive performance improvement. By combining plan data, benchmark data, and standard analytics in a single platform, CapB’s solutions provide competitive advantage health plans needs to drive pharmacy performance across the entire enterprise……

CapB’s healthcare and technology expertise has enabled us in understanding the Certification and Meaningful Use requirements. Our Certification and Meaningful Use solution comprises of assessment services, development services, and validation & testing…….

Workflow Consulting

CapB’s domain and technical expertise helps in existing or building workflows, optimizing clinical and business systems.

Regulatory Consulting

CapB’s domain and technical expertise aligns people, processes and technology to support regulatory compliance and optimize overall performance.

Technical Consulting

: CapB’s domain and technical expertise offers expert insight into current processes, locating inefficiencies and optimizing the value of your technology.

Productivity Assessment

: CapB’s domain and technical experts comprehensively evaluates processes and equipment post-installation to identify potential sources of additional value.

Upgrade Implementation

: CapB deliver key enhancements to help improve organizational and clinical value while reducing disruption and downtime.

Data Migration

:CapB smoothly and securely moves your most important assets onto supported platforms in a way that fits your unique needs

Customization :

Use, CapB’s experienced configuration teams to generate hundreds of custom reports, perform dozens of specialized integrations, and modify thousands of interfaces to provide rapid insight into performance, while enhancing user workflows.

Application Customization -Leverages new features and fine-tunes existing functionality for optimal organizational performance.

Interface Customization – Delivers comprehensive recommendations to better align your interfaces with your business requirements.

Report Customization :Enlists expert writers and robust interpretation to capture new value from existing data. Custom Integration: Optimizes continuity between new or existing software solutions, improving workflow, and helping to reduce human error…….

Even the best systems encounter problems. Achieving 100% uptime is an ambitious goal, especially when on your own. Having a partner that can quickly solve an issue or restore interrupted service is critical to managing internal expectations and maintaining high utilization. Half of our entire service delivery organization is dedicated to providing customer-centered support.These highly skilled teams deliver swift diagnosis, resolution, and prevention of routine and complex issues

Software Maintenance :

Delivers 24/7 designated and online support for swift diagnosis, resolution, and prevention of routine issues

Dedicated Support :

Offers exclusive, flexible, and customized service for customers with complex need


In an unpredictable and complex environment, managing, staffing, monitoring, and securing critical IT solutions can be overwhelming and distract you from your primary goals. Our specialized staff, advanced monitoring technologies, and secure remote facilities allow us to deliver the right solutions for your most pressing challenges.

CapB helps reduce uncertainty and long-term expenses while maintaining your focus on delivering the best patient care..

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