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Referral Optimization

This service helps match patients with specific diagnoses and needs to physicians with demonstrated efficiency and quality for treating those types of patients. 

Proactive Patient Advocate/Concierge Service

Early and ongoing patient engagement is the key to treatment compliance. Initially Monocle assesses, segments and assigns each beneficiary to the appropriate patient engagement program based on health segment.  Then the appropriate program proactively engages beneficiaries to provide support in every possible way (remote patient monitor, appointment assistance, referral optimization, price and quality, etc).  Monocle then monitors patients for new diagnoses so that the patient is contacted promptly and placed in the optimal program upon changes in health. 

Complex Chronic Management

These are high-cost patients with six or more chronic diagnoses who require intense proactive care coordination to ensure patient engagement for reduced costs and better quality of life.     

Price Transparency Platform

Showing prices of tests, office visits and bundled payments for selected procedures in a consumer-defined geographic area. 

Disability Migration

Monocle applies software to identify high cost patients which may qualify for Medicare SSI Disability and marshals them through the process including documentation, hearing preparation, etc.  For health plan sponsors, under ERISA must fund retiree health care plans until the beneficiary reaches Medicare age, this is a major financial potential recoupment – in addition to lowering health care plan costs.  

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Pharmacy Audit Recoupment

PBM contracts are extremely complex, and frankly, not well monitored.  The drugs are tiered based on the Average Wholesale Price (AWP).  But did you know the AWP prices change daily – just like commodity markets – but the PBMs rarely update the price to you?  Monocle applies proprietary software to find those gaps in pricing and helps plan sponsors recoup those funds.  

Cash Prices & Quality Rankings by Procedure

Since Monocle measures provider efficiency it identifies those providers who have excessive costs.  This identifies providers who are likely to be involved in fraud, waste, and abuse. 

Fraud, Waste, and Abuse

Since Monocle measures provider efficiency it identifies those providers who have excessive costs.  This identifies providers who are likely to be involved in fraud, waste, and abuse.  

Provider Directory Maintenance

Monocle’s electronic provider directory service is constantly updated by matching multiple provider databases.  In addition, Monocle provides a robust profile of each provider’s capabilities and sub-specialties/target markets.   

Automated Clinical Guidelines

When Monocle identifies high performing providers, it documents their treatment protocols and offers that documentation to other providers so they can improve their cost and quality. 

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