AVA Systems -Use Case Summary

Designed for patients and members, the Consumer Module provides self-service tools, communication channels, and virtual care options, improving access to healthcare and enhancing engagement.

• CRM – Manages patient interactions, tracks inquiries, and personalizes outreach.
• Messages – Secure messaging system for patient-provider communication.
• JSA (Jump Start Assessment) – Provides members with insights into their healthcare services and eligibility.
• Care on Demand – Enables real-time access to urgent care services.
• Member Enrollment – Simplifies the registration and onboarding process for new members.
• Virtual PCP – Allows members to consult with primary care physicians remotely.
• Telehealth – Provides video-based consultations for remote healthcare delivery.

Developed to enhance provider efficiency and coordination, this module streamlines patient management, scheduling, and service authorization.

• P360 – A comprehensive view of a provider's patients, services, and performance metrics.
• Patient Priority – Helps providers identify and prioritize high-risk patients.
• JSA – Supports providers in tracking and managing Jump Start Assessment scheduling services for patients.
• Virtual PCP – Enables providers to conduct virtual primary care consultations.
• Telehealth – Secure platform for remote patient consultations and follow-ups.
• Care on Demand – Supports providers in delivering real-time, on-demand care.
• AVA Scheduler – Centralized scheduling system for provider appointments and services.
• Authorizations – Manages approvals for treatments, procedures, and referrals.
• Provider Search – Enables users to find and connect with healthcare professionals.
• Provider Data – A centralized database for managing provider credentials, affiliations, and profiles.

Built for healthcare professionals and clinical teams, this module optimizes patient management, care coordination, and medical decision-making.

• Census – Tracks real-time patient admissions, discharges, and transfers.
• Care Anywhere – Supports remote patient care and management.
• Care Management – Facilitates case management and long-term care planning.
• Utilization Management – Monitors and optimizes the use of healthcare services.
• Patient 360 – Provides a holistic view of a patient’s medical history and current status.
• Coder 360 – Assists in medical coding and ensures accurate billing and compliance.
• Panel Management – Organizes patient panels for population health management.
• Patient Priority – Helps clinical teams focus on high-risk patients needing urgent care.
• Dashboards – Visual reports and analytics for clinical performance tracking.

 Supports administrative and back-office functions to ensure efficient claim processing, compliance, and reporting.

• Member Enrollment – Handles new patient registrations and eligibility verification.
• Claim Auditor – Reviews and audits insurance claims for accuracy and fraud detection.
• Audit History – Tracks all changes and actions taken on claims and member data.
• Claim Inquiry – Allows real-time tracking and resolution of claims and disputes.
• Encounter 360 – Provides a full view of patient encounters across all care settings.
• Provider Data – Centralized database for managing provider credentials and affiliations.
• Authorizations – Processes and tracks treatment and procedure approvals.
• Utilization Management – Ensures appropriate resource allocation for healthcare services.
• Agent Work List – Helps administrators track and manage daily tasks efficiently.
• Reports Submission – Automates the submission of regulatory and performance reports.
• Appeals and Grievances – Manages patient appeals and formal complaints.
• Provider Appeals and Disputes – Handles provider-initiated appeals on claims or service decisions.