Welcome to Emidence®: Xybion’s Integrated Low-Code Workplace Health, Safety, Care, Case and Claims Management Digital Platform meeting the needs of all stakeholders along the care path of an employee – pre- and post-injury

Whether you are an employer, a health care provider or a payer, we have a solution for you. Digitally follow an employee through the Workers’ Comp system lifecycle, making the right workplace health, safety, post-injury care recommendations at the right time. We believe that good partnerships drive good business. We enable our end users to do what they do best, focus on their core business. Imagine being able to digitally follow an employee through the WC system each step of the way. All stakeholders are able to have a full view of activity that impacts their decision making, before and after an injury.

We provide just that. Xybion’s Workplace Health Platform delivers a gold standard solution for the Occupational Health & Safety Ecosystem. Emidence’s rapid configuration capability ensures that your personalized solution will meet your immediate needs, and scale rapidly as needed to support future functionality requirements without disrupting current business operations. Validation rules, robust access controls, integration of all data & activities into a single database and audit trails promote data integrity reduces staff training time and system support costs and streamlines reporting activities thereby lowering total cost of ownership. The combined solution offers modules for the three main groups of workplace health.

Modules supporting the employer include:

  • Health & Safety, Incident Management
  • OSHA reporting
  • Case Management
  • Return-to-Work Management

Modules supporting Providers, Clinics and Health Systems include:

  • Health & Safety
  • Injury Management specific to workers comp type injuries
  • Network Management including credentialing and Delineation of Privileges (DOPs)
  • Medical Billing and Revenue Cycle Management

Modules supporting the Insurance Carriers and TPA’s include:

  • Claims Management
  • OSHA Reporting
  • Case Management with Return-to-Work
  • Network Management
  • Medical Bill Review

The possibilities are endless. Xybion’s platform is modular enabling partners to combine one or several modules to create a unique custom platform meeting business needs. The applications are built in low code, are configurable, and integrate with internal systems as well as ancillary vendors.

Build Your Process – Your Way

SCENE 1: Lifecycle of an Injury Through the Digital Platform
Let’s visualize the platform we introduced through the following scene.

Here’s Freddy. Freddy is late for his next meeting at the other end of the building. Freddy is running through the hallway, a safety violation to begin with. Someone dropped a pen and didn’t realize it. Freddy slips on the pen. Freddy falls backward, onto his back.

SCENE 2: Incident Report, Investigation and OSHA Reporting
Utilizing the Health and Safety Module, Freddy can log this incident directly into Emidence through a self service portal authorized by the employer. Freddy’s risk manager pulls Freddy’s employee demographic information from the human resource system and is guided through a series of questions to gather pertinent information to send to the employer’s carrier or third-party administrator. The third-party administrator will load the injury detail into the claims management system to establish a claim or report only incident.

If it is determined that this is an OSHA reportable event and that medical care is needed, the injured employee will be referred to a care clinic. The required OSHA form, 300, 301, 300A,  will be auto-populated by the system with the information gathered. The OSHA team can review and auto-upload the reports into the OSHA portal

Freddy’s supervisor can initiate an investigation using Emidence’s inspection and CAPA modules, close the inspection and put corrective actions and new training in place by using Emidence’s ECM module

SCENE 3: Case Management, Return to Work and Industrial Hygiene
Emidence Case management module automatically creates a case and is immediately available to the case managers.

  • Case managers can log all communications, SMS text send from the platform into the database.
  • The built-in ODG (Occupational Disability Guideline) provides planning guideline for absence and Return-to-work estimates.
  • Built-in job requirements in Emidence helps the case manager find alternate jobs for the person if not able to meet the requirements of the original job pre-injury.
  • Industrial Hygiene can carry out investigation, if needed, and close the case.
  • Environmental screening, monitoring, respiratory and hearing PPEs can be issued and fitted using Emidence’s Industrial Hygiene and Inventory modules

SCENE 4: Patient Portal & Physician Office Visit and The Encounter
The injured employee will visit the patient portal of the physician’s practice management system to pre-fill basic health information. Details about the injury are automatically pulled into the physician’s system through our integrated model.

  • Pre-populating the OSHA form saves administrative hours and ensures compliance.
  • Pre-populating the physician system via the patient portal saves employee time and facilitates a smoother office visit

The physician will sign into the practice management module and be guided through a series of evidence-based, injury specific guidelines. When the physician completes the assessment, the physician will lock the record and automatically send the medical bill and medical notes through the billing platform electronically to the carrier or third-party administrator.

  • The evidence-based, injury specific guidelines embedded in the system guarantees a clean medical bill is populated when the encounter is complete.
  • Locking of the record immediately at the completion of the encounter and automatically submitting it to the billing team reduces transcription hours and facilitates prompt filing and faster time to payment.
  • Automatic submission of the bill to the payer eliminates the printing and faxing of medical notes as well as follow-up calls requesting missing notes. Administrative time is saved as well as administrative costs.

SCENE 5 & 6: Bill Received by Payer and Sent to Medical Bill Review
The carrier will log back into the claims platform and see that a bill has been received.

  • The carrier may set up a claim or link the bill to an established claim.
  • The carrier electronically sends the medical bill and notes to bill review.
  • Once the bill is released to the medical bill review engine, the bill will be evaluated further for carrier specific business rules, state rules, network application, and recommendation of payment.

The integrated system enables the carrier to see the stage the employee is in throughout the lifecycle of the claim.

  • Reduces lost bills and associated documents by linking all associated bills and notes to the employee systematically
  • Reduction of paper handling and associated administrative tasks associated to mail room functions are decreased
  • Medical Bill review is completed more quickly, enabling faster payments and in some cases, return-to-work.

The carrier will release payment to the provider and attach to the claim file within the claims management system the documentation supporting payment.

Conclusion
What does all of this mean for you? No matter what role you play within the workers’ comp system, we’ve created a way that you can have a holistic view of the employee through the WC system, pre and post injury.

  • Xybion’s combined solution is more powerful than any competition Xybion offers a total end-to-end solution powered by one source of truth. Gone are the days of merging data from multiple sources and piecing together multiple solutions.
  • Xybion bridges the gap between stakeholders delivering customized solutions from one cloud – one core database – with multiple interconnected apps.

Xybion’s Health and Safety Management Software helps simplify the complex evidence-based documentation activities and compliance processes of Occupational Health and Occupational Medicine through automation of end-to-end health & safety workflows.

Experience healthier workers, lowered total cost of administration, improved compliance and reduced risk with Emidence.

Employee Health, Safety & Environment Management​

Automate, manage and control workplace health and safety workflows via our rapidly deployable, easily configurable Employee Health and Safety Management application. Manage workplace health and safety across multiple sites (locally, regionally, nationally, globally) within your organization from one digital cloud. Our employee risk and safety management module is specifically designed for occupational health and seamlessly integrates with internal and external systems.

  • Manage Workforce Safety and Security
  • Manage employees, organizations, locations, job roles
  • Track training, certifications, licenses
  • Conduct inspections, investigations, report findings and create CAPAs (Corrective Action & Preventive Actions)
  • Manage Employee Health, Immunization and Compliance, Industrial Hygiene and Environmental Exposures

Employee Health, Safety & Environment Management

Total Incident and Workplace Safety

OSHA Reporting

Automated OSHA management process

Case & Return-To-Work Management

Rapidly configurable for your business

Workers’ Comp

Evidence-based Care, Claims & Compliance e-Platform

Employee Health Services

Evidence-based Care, Claims & Compliance e-Platform

Payors, TPAs & Managed Care Providers

Workers compensation claims are complex and regulated by each state and as such, require a system that integrates data and documents from multiple constituents into a single electronic case folder.  Data from the employer, medical examinations from the providers, compensation board determinations, prescriptions, treatments, re-evaluations and often appeals are collected as part of a typical workers’ compensation case.  Having a system that is the single source of truth supported by robust workflow and data analytics is crucial in the ever-changing workers compensation landscape.

Our software for Payors and Managed Care providers is configured to support a wide variety of workers compensation claims – including work-related injury, occupational disease and workplace incurred fatality – as well as specific agency, regulatory and business requirements.  It manages the nuances of each state. In addition to the core functionality, the solution manages speed, compliance and ease of use are at the core of our web-based platform. By helping you excel at all of those key competencies in handling workers’ comp claims, your core business operations improve by being more accurate, more often, in bill review, compliance, and managed care. We can help you:

  • Increase productivity
  • Lower claim costs
  • Ensure compliance with regulations
  • Empower better outcomes

Claims Management System

Total Incident and Workplace Safety

Medical Bill Review

Modern technology, rapidly configurable rules engine-driven work flow options and an embedded document management system allow for almost infinite custom configuration possibilities. “Your Process – Your Way”.

Network Management and Credentialing

Digital low-code cloud platform manages real time data, quality, compliance, and data integrity for existing and new provider networks from a single, integrated platform.

Providers

Integrated EHR, Bill Review, Medical Billing and Revenue Cycle Management

The primary and the most common cause for the delayed and reduced cash flows for providers is inaccurate medical billing. Our cloud-based platform can prevent such discrepancies and provide with a hassle free and an accurate medical bill. This can improve your work flows and cash flows and gets your payment to you on time.

Emidence’s EHR platform was built on the premise that Workers’ Compensation processes could be dramatically streamlined and improved in the areas of utilization review and reduction in denials.  We built a first-in-class, evidence-based EHR solution that was optimized for the Workers’ Compensation marketplace and then built out a complete EHR solution focus on musculoskeletal injuries and also  capable of managing a variety of practice areas from start to finish

Bill Review Integration

Our bill review platform seamlessly integrates with the EHR platform. Bills can be directly sent from EHR to Bill review without requiring any additional costs.

The system optimizes and integrates the work flow processes with the core functions of the Claims Management Software.

  • Instantly available to a bill reviewer
  • No additional costs for mailing or clearing houses
  • Accurate, compliant, scalable and efficient
  • ICD-10 support
  • Fee Schedule integration

Digital Billing and ICD-10 Integration

ICD-10 engine is built natively into the Xybion Health platform.  The solution creates medical bills for review that incorporate ICD-10 codes right from the exam room.

  • Get Paid Faster
  • The platform reduces claim errors because of the built in ICD-10, National Fee Schedules and evidence-based treatment plans.
  • Test Run a complete bill review

Before submitting the claim, providers can run a mock bill review to look for errors that may trigger a claim error or denial, resulting in slower payment.  The platform will give you certainty behind your claims so you know exactly how much will be reimbursed, improving your practice’s revenue forecast.

Electronic Health Records (EHR)

Complete, evidence-based EHR that works the way you work

Medical Billing and Revenue Cycle Management

Medical Billing and Revenue Cycle Management for all Providers

Provider Credentialing & Privilege Management

Real-time on-boarding, verify, approve and manage delineation of privileges(DOPs) across multiple sites