Overview

Centricity™ Financial Risk Manager is a proven, highly customizable and provider focused technology solution that helps streamline management of administrative costs, utilization, and coordinated care of patient populations by providing a technology platform and advisory services.

Centricity Financial Risk Manager serves healthcare organizations engaged in risk-based contracts spanning from shared savings to global capitation.

Proven track record 
More than 30 prominent healthcare systems in the U.S. use Financial Risk Manager to help them efficiently manage risk and control costs associated with managing patient population across a health system.

Highly customizable and scalable 
Healthcare organizations can use Centricity Financial Risk Manager to customize workflows based upon specific organizational needs. Centricity Financial Risk Manager can scale with the size of the population.

Focused on providers

Unlike traditional payer-focused products, Centricity Financial Risk Manager was built to meet the needs of providers taking on risk. The solution has served provider institutions directly taking risk with payers or through self-owned health plans.

Features

Helping you manage risk

Centricity™ Financial Risk Manager offers comprehensive solutions for provider institutions, health plans, and accountable care organizations that manage partially or fully capitated risk-based contracts as a part of the journey toward value-based care delivery. The solution includes the following capabilities:

Enrollment 
As the core of Financial Risk Manager, the Enrollment module collects demographic, insurance and enrollment data including employer, physician and benefit information. It enhances the enrollment workflow and supports a wide spectrum of user-defined benefit plans that can be linked to multiple employer groups.

Referrals
 The Referrals module simplifies task management and streamlines the workflow with automated referral queues and the ability to flag referrals based on rules, procedure or diagnosis codes, or other criteria as specified by your organization.

Claims 
The Claims module automatically adjudicates claims entered manually or through Electronic Data Interchange (EDI). It enables you to manage a variety of reimbursement arrangements including withholds, discounts, per diems, RVUs, DRGs, and APCs, and facilitates streamlined processing of individual or groups of claims. 

Capitation and risk management 
The Capitation and Risk Management module helps you manage and administer reimbursement arrangements with primary and specialty providers. It enables you to track and monitor reimbursement to capitated providers and medical groups, as well as flexibly administer withhold and stoploss arrangements.

Premium billing 
The Premium Billing module enables you to calculate and produce premium bills for employer groups and self-pay members, manage receivables, and administer broker commissions. You can flexibly negotiate rates with employers differentiated by member type, employer group, benefit plan and other variables. 

Case management 
The Case Management module supports your quality of care initiatives and helps you manage the cost of complex and high-risk episodes of care. It enables case managers to identify cases, track care plans, simulate costs of care under different scenarios, generate form letters and link multiple service records related to a single case. 

Customer service 
The Customer Service module is a comprehensive call and task management system that enables you to respond to your customers’ needs quickly and easily. It enables you to capture data related to calls and correspondence, categorize and track issues, and calculate expected turnaround time. 

Electronic Data Interchange (EDI) 
Financial Risk Manager comes with standard EDI transaction sets that include Healthcare Claims (837), Healthcare Remittance (835), Referral Verification (278), Eligibility (270/271), Claim Status (276/277), Premium Payment (820), and Enrollment (834).

Services

Amid industry upheaval, healthcare organizations are under greater pressure than ever to be productive. Only by getting the most out of every tool can you deliver the care patients need with the efficiency the market demands.

GE Healthcare’s IT Services are designed to connect productivity with care by increasing usability, enhancing performance, and optimizing a solution’s return on investment.     

   
Consultation

Increases employee and IT system productivity with Workflow Consulting, Regulatory Consulting, Technical Consulting, or Productivity Assessment.   
 
Learn about Meaningful Use Consulting services


  GE Healthcare Services Education 
Education

Drives understanding and increases adoption by leaders and staff through Master Trainer Education and/or End User Education services.  
  GE Healthcare Services Implementation 
Implementation

Delivers high adoption right from the start with Software Implementation, Upgrade Implementation, or Data Migration services.
  GE Healthcare Support 
Support

Reduces unplanned downtime, promotes resilience, and enhances usability throughout your IT systems lifecycle with Software Maintenance and Dedicated Support services.  

Visit the Healthcare IT Service Portal

  GE Healthcare Services Customization 
Customization

Diminishes disruptions, responds to required changes, and optimizes productivity through Application Customization, Interface Customization, Report Customization, or Custom Integration services.   
  GE Healthcare Services Enablement 
Enablement

Reduces uncertainty and long-term expenses while staying focused on your organization’s patient care mission through Asset Management, Remote Monitoring, or Business Continuity services.

Some services may not be available for specific products.

Learn More


Resources

Brochures

Case Studies

Customer Testimonials

Webinars

White Papers

Industry Knowledge Center

Customer Reference Program