KLAS Report

We did look at the decision more from the perspective of our long-term growth strategy, and we felt Jiva offered the best opportunity for us to build on the Jiva platform as a backbone to building other things. We decided to move forward with the care management module for certain lines of business as well. We are using the appeals module, and we will be looking at other potential modules as we look to expand business for certain patient members, some of whom had some very specific requirements that ZeOmega has already met for our state. That is a state Medicaid problem for certain individuals. It was part of our future growth strategy to have a nimble, state-of-the-art technological platform from which to build things for our medical management, utilization management, care management, quality, and other needs. I think we made the right choice in doing that.

Previously, we were using multiple utilization management platforms for various products and lines of business. We consolidated those into a singular platform for utilization management through an RFP process. ZeOmega was part of that contingent as well as other industry leaders, and we worked together with a consultant to help identify and prepare an RFP that was undertaken. Through that process, we went through a rigorous scoring, interviewing, and reference-checking process to identify our finalists, from whom we ultimately recommended and selected a candidate. We chose ZeOmega for their utilization management platform. The goals there were to reduce the technological redundancy of platforms and the support and maintenance of those platforms and to improve operational efficiencies within our utilization management team. We had different teams working on different platforms, and that really hindered our ability to flex staff and support each other more in real time across products.

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The goal was to get a state-of-the-art system that could help grow with us as we grew our membership and our plans and strategy for our insurance but that could also reduce the administrative burden of managing multiple platforms and improve the operational efficiency of moving from multiple platforms to a singular platform. We also wanted to meet all our regulatory and contractual requirements in that process with our clients.

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Jiva is a great product. We are helping to integrate it with functionality with our claims and administration platform, and the integration seems to be working. There are a lot of products out in the industry, and we have a lot of salespeople calling me because they want me to switch, and we say no because we have a great product. I don't know who the ZeOmega service people are personally, but we have a great product in Jiva. Long term, we have made a significant financial commitment, and we have built the product up. It is working, so we are not going anywhere. We would recommend Jiva. We are also helping others who are moving onto ZeOmega’s platform. Also, ZeOmega is a little better at relationships and servicing with us and working with us than another vendor.

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ZeOmega is an expert in what they do. They are very available and accommodating. They help us work through things. We did an upgrade that had a few issues, and one of the vendor's executives worked through the weekend to make sure we met our deadline. I haven't worked with any other entity that has delivered that level of commitment.

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We have pretty much every module ZeOmega has put out. I don't think that there is anything else that we need the vendor to do. ZeOmega is always looking to see what else they could do that would help us. They are always supporting us and checking to make sure we are good.

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ZeOmega's upgrades have been exactly what we expected, but the vendor has handled them very well. That has made me very comfortable with them.

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The system is very easy to configure. It is really user friendly.

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The Jiva application is easy to configure. It is easy to use from an administrative perspective. System administrators have an easy time understanding the application. The application was unidirectional, but now it is bidirectional, so it is easily used.

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We get our money's worth for what we pay. Our ROI calculations have shown a lot of value.

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Jiva works with other products in terms of integration. ZeOmega definitely supports our connection with our claims system. So, we are able to pay claims based on our authorization decisions. We also utilize Jiva as a member portal so that we can have our members see information about themselves. And we utilize the provider portal so that we can have providers send us authorizations without having to call us or fax us.

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ZeOmega is a great company. I can always get them on a call within about 15 minutes when I have an issue. The vendor's support is excellent. Jiva is a very stable product, and our business users love it. I am very satisfied with the vendor as a true partner.

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ZeOmega does a good job with upgrades. They tell us everything that will change and how things will look. We can walk through things, see demos, and test things.

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I work very closely with our account executive. ZeOmega has great employee longevity. I have had the same contact people for several years. With other vendors, we get a new contact person every other month. I also like that ZeOmega’s people use technical language.

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ZeOmega has worked with us over the years to do as good a job as they can customizing the application to our environment to meet our needs, but the fact that our system is so customized and has tons of back-end interfaces creates a lot of work, and it takes more effort to work through a third party solution than a homegrown one. Ultimately, the whole purpose of Jiva is to drive and track our member interaction, and that leads to better health outcomes.

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ZeOmega allows us to build a lot of things on our own, and that really saves us a lot of money. We just got some new technology from ZeOmega, and that technology was pretty good. Jiva is a great product. We truly enjoy having it.

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Our account management team from ZeOmega is great. Our account representatives are fantastic. They are very responsive, and they coordinate regular leadership calls with us. They keep a running list of topics, and if we have an issue that needs to be escalated between calls, they are very responsive. They make sure that they pull all the right people together for whatever conversation needs to take place.

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ZeOmega is very intentional about knowing what is going on in the healthcare industry. They do a good job of staying in front of things.

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The biggest advantage of this software is that it allows us to customize things to meet our workflow without having to go to the vendor. That increases our speed and flexibility and meets the needs of our organization. Sometimes when we have short turnaround times for things that need to be done for regulatory bodies, we can build things and implement them ourselves. That is a great piece of this tool and one of the reasons why I am so satisfied with it.

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We have had a very positive experience with the care management system. We have had complex needs and data, so while the product has struggled through the years, it has met our needs. From both a nursing and a leadership perspective, we have been very happy with the product. Everything in the system has been at our fingertips. We have been able to link a lot of systems that users have historically had to log in and out of, and those systems have been interfaced with Jiva. It has been helpful to

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I have been extremely impressed with how little downtime we have had. The product is ridiculously reliable and really easy. The product is amazing. I can’t say enough positive things about the product’s reliability.

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In terms of outcomes, the product has certainly improved our efficiency, data mining and reporting capabilities, care coordination between business departments, and communication with providers and members.

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Prior to implementing Jiva, we hadn’t been meeting certain requirements. Once we implemented the product, we went from struggling to meet even a percentage of the requirements to meeting all of the requirements every month. That was really good. Because the utilization management and practice management sides of the system were closely integrated, Jiva allowed us to have access to certain data in order to meet our goals. So, we can certainly look at our outcomes with the system.

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ZeOmega offers a lot of APIs and data integration with EMRs. The vendor is very on top of interoperability. ZeOmega partnered with our other third-party vendor to create an ePA process to help us with automation with our prior authorizations.

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Whenever we have had to escalate to the executives, they have been willing to jump on a call with us and talk through things. The executives are pretty involved.

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We have definitely hit our outcome goals with Jiva. The utilization management portion of the solution is particularly strong as well as the appeals portion. Those are two complex parts of our business, and with ZeOmega’s automated logic rules and the way they have designed the system, things are handled really well. There are a lot of timeliness concerns that impact those two areas, so those functions are particular strengths of the solution.

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What is super nice about the solution is that all of the parts for care management, appeals, and utilization management are all on the same database and the same platform. For example, if we are doing a utilization management review on a member, we may have denied a service because it is not coming in as medically necessary. If the member has an appeal against that, we can see everything that has happened with that member from case management to utilization management.

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We get great support from ZeOmega. The people that we work with on a daily basis are able to solve our problems. We get training whenever we need it and ask for it. I can go right up to the executive level at ZeOmega if I need to. Their senior executives are very accessible. They never hesitate to get on a call. We have regular meetings, so I do think they are very involved at the client level, and that is nice.

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ZeOmega does a very good job of staying relevant with the changing healthcare landscape and incorporating all of the different new components, such as social determinants, long-term care benefits, and population health management.

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