MISSION STATEMENT:

 CURRENT PROBLEMS FACING PROVIDERS EVERYDAY:

Throughout a patient’s continuum of care, plan sponsors, employers and patients are often frustrated with the processes that are required to diagnose an issue, create a treatment care plan that meets the patient’s needs, and implement services that allow providers to be paid timely and correctly for their services. This is largely due to three factors:

  1. Insurance and industry changes that happen yearly, quarterly, and in some cases monthly…… providers simply can NOT stay up to date with coding and documentation requirements

  2. Inefficient Supply chain management and payor reimbursement create a high cost burden that lead to uncertainties in being paid appropriately for services rendered

  3. Providers of services become frustrated, staff become burdened with excessive work and patient care suffers. 

INSURANCE CHALLENGES WITH ADMINISTRATION:

ERISA guidelines govern how plans are funded and how funds tied to those policies are supposed to be administered. Since the Affordable Care Act (ACA), insurance payors have implemented policies that place the financial burden on the treating provider and/or patient to implement care services. The policies are designed to partially pay, deny, or delay approvals. This causes undue stress on all parties in the healthcare system. This includes the provider of services, plan sponsor and most importantly the patients. These policies are designed to increase insurance payor profits.

SOLUTIONS:

KOKUA MEDICAL VENTURES provides a centralized platform that integrates all parties within its platform (practitioners, patients, manufacturers and wholesale partners) throughout the entire patient continuum of care to counteract these inefficiencies.   

From patient registration to patient release, the patients, practitioners, and suppliers all work together in one ecosystem that allows KOKUA MEDICAL VENTURES to offer patients a customized approach to care. This ensures medical necessity and proper documentation is met allowing providers to be paid for services and staff to receive the support that they need to get a claim paid. This process helps identify care plans that will provide patients a better overall experience.