InterQual® solutions, from Change Healthcare, allow organizations to reduce over- and underutilization for optimal care, align with other stakeholders, support physician and care manager performance management, and increase defensibility of decisions to lower risk. The comprehensive InterQual portfolio includes evidence-based clinical content for levels of care, imaging, procedures, molecular diagnostics, DME, behavioral health, retrospective monitoring and coordinated care as well as clinical evidence summaries.
InterQual Connect™ is a flexible cloud-based solution integrated into the Jiva platform that combines InterQual content and authorization connectivity. It promotes transparency between payers and providers by establishing and sharing a common language of evidence based criteria, and reduces the administrative burden of the prior authorization process by enabling the automation of all authorization requests, even those that require a medical review.
Clearlink Partners is an industry-leading managed care consultancy specializing in end-to-end clinical and operational management services and market expansion initiatives for Managed Medicaid, Medicare Advantage, Special Needs Plans, complex care populations, and risk-adjusted entities.
Clearlink support organizations as they navigate a dynamic healthcare ecosystem by helping them manage risk, optimize healthcare spend, improve member experience, accelerate quality outcomes, and promote health equity.
Healthwise provides care managers and physicians with a powerful resource that engages people to take an active role in their health. Healthwise member-friendly health education is fully integrated with Jiva. The integration allows health plans to access Healthwise® Knowledgebase, Healthwise® Care Support Pages, Healthwise® Ix® Patient Instructions, Healthwise® Ix® HealthMastery® Campaigns, and Healthwise® Ix® Conversations from within Jiva-streamlining and automating the delivery of this important content to its members, physicians, and the care community. Everything care managers and physicians need to support the people they serve.
MCG Health, part of the Hearst Health network, helps health care organizations implement informed care strategies that proactively and efficiently move patients toward health. With powerful elements of the MCG Cite solution fully integrated into ZeOmega’s Jiva, MCG’s transparent assessment of the latest research and scholarly articles – along with data analysis – gives payers the vetted information they need to feel confident in their care management decisions. For this reason, eight of the ten largest U.S. health plans use MCG evidence-based guidelines and software.
Wolters Kluwer Health helps healthcare organizations improve clinical effectiveness by providing solutions that help balance the quality / cost equation. Through our integration with the Jiva platform, our decision support solutions provide insights within the healthcare workflow to help control costs, maximize revenue, adjudicate claims, and enhance market research. Medi-Span® powers pharmacy systems with drug data for therapeutic classification and clinical screening. Medi-Span Price Rx® provides timely drug pricing analysis. Lexicomp® and Facts & Comparisons® help professionals make safe medication decisions with point-of-care drug references. UpToDate® offers evidence-based treatment recommendations. Together, these solutions provide consistent healthcare guidance to support business decisions and enhance patient care.
This is ZeOmega’s report on our service organization’s system and the suitability of the design and operating effectiveness of the controls. It reports on controls at a service organization relevant to security, availability and confidentiality. SOC 2® reports are examination engagements performed by a service auditor (CPA) in accordance with AT Section 101, Attest Engagements, of SSAEs (AICPA, Professional Standards) using the predefined criteria in TSP section 100, Trust Services Principles, Criteria, and Illustrations for Security, Availability and Confidentiality. SOC 2 reports specifically address the following key system attributes:
Security – The system is protected against unauthorized access (both physical and logical)
Availability – The system is available for operation and use as committed or agreed
Confidentiality – Information designated as confidential is protected as committed or agreed
Drummond Group LLC offers comprehensive compliance, security, risk management, surveillance, and education services to healthcare, financial and other regulated industries. As an Authorized Certification Body (ACB) and an Accredited Test Lab (ATL) within the Office of the National Coordinator Health IT Certification Program, Drummond specializes in working with health IT developers to test and/or certify their software for use by healthcare providers in regulatory programs.
The Jiva platform, Jiva private cloud, and information systems infrastructure earned Certified status for information security by HITRUST on May 4, 2021. HITRUST CSF Certified status demonstrates that ZeOmega’s Jiva platform, Jiva private cloud, and information systems infrastructure have met key regulations and industry-defined requirements and is appropriately managing risk. This achievement places ZeOmega in an elite group of organizations worldwide that have earned this certification. By including federal and state regulations, standards, and frameworks, and incorporating a risk-based approach, the HITRUST CSF helps organizations address these challenges through a comprehensive and flexible framework of prescriptive and scalable security controls.
Jiva Achieves HEDIS MY2023 Allowable Adjustment Certification
ZeOmega has received certification for its healthcare enterprise management platform, Jiva, for NCQA HEDIS Allowable Adjustments Certified MeasuresSM MY2023. NCQA’s HEDIS Allowable Adjustments (AA) Measure Certification is precise, automated testing that verifies compliance with the Rules for Allowable Adjustments of HEDIS. ZeOmega selected 41 measures that reflect the broad range of coverage provided by Jiva for identification and management of population healthcare issues across the continuum including health and wellness indicators for preventive health and screenings, age- and condition-related measures such as Care for Older Adults, Controlling High Blood Pressure, and Childhood Immunization Status as well as multiple behavioral health measures. Using Jiva’s Care Reminders permits our clients to proactively monitor performance and provide needed interventions to enhance effectiveness and quality of care for their members.
Jiva became a prevalidated solution in 2018 when NCQA’s PHM Prevalidation program began and its PHM Prevalidated status continues, uninterrupted, through 2024.
With this Prevalidation, our clients benefit from reduced burden for Health Plan Accreditation (HPA) as well as Population Health Program (PHP), Managed Behavioral Health Organization (MBHO), or Case Management (CM) accreditation elements designated as eligible for automatic credit or plan support. Because Jiva has been rigorously tested and proven to ease administrative workload, organizations invested in our solutions will regain precious time to focus on patient-centric care and the improvement of overall health outcomes.
The Sequoia Project—an independent advocate for the implementation of a secure, interoperable, nationwide health information exchange (HIE)—has validated Jiva HIE Connect 6.0.2 for use with the eHealth Exchange.
The Sequoia Project developed the eHealth Exchange Product Testing Program to provide a high degree of assurance that participating systems conform to eHealth Exchange Performance Specifications and can interoperate with other systems without error or further customization.
Having successfully passed the eHealth Exchange Product Testing Program’s rigorous conformance test, Jiva HIE Connect can now exchange data with the largest HIE in the United States.
ZeOmega has achieved full Trusted Dynamic Registration & Authentication Accreditation Program (TDRAAP) – Comprehensive accreditation from the Electronic Healthcare Network Accreditation Commission (EHNAC). Developed in collaboration with UDAP.org, TDRAAP-Comprehensive supports interoperability requirements within the Office of the National Coordinator’s (ONC’s) Cures Act Final Rule and related CMS Interoperability and Patient Access Final Rule.
TDRAAP-Comprehensive combines the extensive privacy and security requirements and in-depth validation of traditional EHNAC accreditation programs, with UDAP technical framework certification. It is designed for a diverse cross-section of organizations and systems choosing to demonstrate full HIPAA/HITECH Privacy Security compliance and supporting all relevant UDAP workflows including those for privileged client app or provider access such as in bulk data, broadcast, or targeted cross-organizational queries.