Posts Tagged ‘Hospital’
GeriJoy and Pace University Win Pilot Health Tech NYC Award to Introduce Avatar-Based Caregivers to Mount Sinai Hospital System
GeriJoy and Pace University Win Pilot Health Tech NYC Award to Introduce Avatar-Based Caregivers to Mount Sinai Hospital System
New York, NY (PRWEB) July 03, 2014
After a highly competitive screening process, Pilot Health Tech NYC, a partnership between New York City Economic Development Corporation (NYCEDC) and Health 2.0, announced $ 1 million in grants to fund the adoption of innovative healthcare technologies in New York. GeriJoy and Pace University are among 11 award-winning innovator/provider pairs. GeriJoy and Pace will conduct a pilot, budgeted at close to $ 250,000, to introduce avatar-based care services to Mount Sinai Queens Hospital.
“We are honored to have been chosen by NYCEDC, Health 2.0, and their panel of experts for this award, and we are thankful for our continued partnership with the outstanding team at Pace University,” said GeriJoy CEO Victor Wang. “The city of New York is a hotbed for healthcare information technology and entrepreneurial activity, and with the phenomenal support that we are receiving through Pilot Health Tech NYC, I know that GeriJoy will make a great impact on the healthcare and startup ecosystem in NYC.”
GeriJoy provides virtual care services through the GeriJoy Companion, which appears as a lovable dog or cat in a specially configured tablet device, available to an elderly person round the clock. Through the live support of GeriJoy’s remote care staff, who see and hear through the camera and microphone on the tablet, the pet talks with the older adult intelligently and compassionately about topics including family photos, news, and daily routines, providing companionship, stimulation, and family connection with no technical abilities required of the older adult.
The GeriJoy Companion reports back to caregivers to provide increased clinical insight and awareness of the patient’s condition. One of the aims of the Pilot Health Tech NYC project is to harness GeriJoy’s cost-effective, round-the-clock companionship and oversight to help mitigate danger due to delirium, the most common complication of hospitalization of older adults. Studies show that total direct healthcare costs attributable to delirium may range from $ 38 to $ 152 billion per year in the US.
“This simple to use avatar-based technology is a one-of-a-kind 24/7 companion to older adults, especially successful for dementia and delirium patients as we found in our beta pilot studies,” said Professor Jean Coppola, PhD, of Pace’s Seidenberg School of Computer Science and Information Systems. “Families showed extreme gratitude for the virtual companionship for their loved one with the tablet-based cat or dog. Live, behind-the-scenes, well-trained staff offer families peace of mind.”
“GeriJoy has proven itself to have a major impact on quality of life for older adults,” said nursing professor Sharon Wexler, PhD, RN, of the College of Health Professions at Pace. “We are very excited to bring this cutting edge technology to older adults hospitalized at Mount Sinai Queens.”
During the pilot at Mount Sinai Queens, inpatients who enjoy their GeriJoy Companion during their hospital stay will have the option to take their GeriJoy Companion home, where, in addition to providing general companionship and oversight, it will serve as a health coach to prevent readmission to the hospital. Under GeriJoy’s new CORE (Clinical Observation, Reporting, and Evaluation) Program, GeriJoy Companions can be assigned to ask patients specialized questions about their daily behavior, tailored to their clinical risk factors. The GeriJoy CORE Program focuses on three primary risk factors for preventable hospital readmissions, which hospitals are penalized for under the Affordable Care Act: heart failure, acute myocardial infarction (heart attack), and pneumonia.
For example, propping up the legs of a congestive heart failure patient when sitting is an effective way to reduce risk for further complications, and one of the questions asked by the GeriJoy CORE Program of heart failure patients is, “Have you been propping up your legs when you sit down?” The data resulting from these friendly coaching conversations are analyzed by GeriJoy and reported to clinicians such as registered nurses or care managers, who use the insight from real-time alerts as well as weekly summaries and trends to better evaluate and mitigate risk factors for hospital readmission. PricewaterhouseCoopers reports that preventable hospital readmissions cost the U.S. health care system an estimated $ 25 billion annually.
Pace and GeriJoy were originally introduced through Pilot Health Tech NYC’s matchmaking events in 2013. Pace had already completed a pilot study investigating the therapeutic and quality of life benefits of the GeriJoy Companion for the elderly, using resources from a Verizon Foundation grant it received to support innovative technologies. The study, entitled “I Am Dougie, Your Virtual Service Dog: An Intervention to Address Loneliness in Older Adults,” was conducted with home-bound seniors at Henry Street Settlement in Lower Manhattan. Findings included “improvement in speech, attitude, outlook, and behavior” of the older adults, who were originally “apprehensive,” “uncooperative,” and “belligerent.” Results were presented at the Aging in America 2014 conference and published in IEEE LISAT (Long Island Systems, Applications, and Technologies) 2014.
“Victor Wang, whose genius created the GeriJoy, has been listening to our feedback and continuously improving upon his amazingly creative and insightful technology which uses a tablet computer to connect isolated older adults with live human responders 24/7,” said nursing professor Lin Drury, PhD, RN, of Pace University’s College of Health Professions. “In our upcoming Pilot Health 2014 project the virtual service dog not only serves as a companion, but as a good natured health coach.”
About GeriJoy
GeriJoy Inc. was founded by MIT researchers Victor Wang and Shuo Deng to improve quality of life for seniors and caregivers through friendly technology. The GeriJoy Companion, their flagship service, is a virtual, talking pet that is backed by GeriJoy’s worldwide team of 24/7 care staff. These dementia-trained remote caregivers guide the pet’s speech to provide elders with the experience of having an always-available conversational companion and friend. In addition to improving mental health for elders, the GeriJoy Companion provides peace of mind and valuable care management insight for family members and caregivers, through the web-based GeriJoy Family Portal. GeriJoy has been recognized by organizations like AARP, TEDMED, and the US Senate as a leading innovator in senior care. For more information, please visit http://GeriJoy.com.
About Pace
A private university, Pace has campuses in Lower Manhattan and Westchester County, N.Y., enrolling nearly 13,000 students in bachelor’s, master’s, and doctoral programs in its Lubin School of Business, Dyson College of Arts and Sciences, College of Health Professions, School of Education, School of Law, and Seidenberg School of Computer Science and Information Systems. The gerontechnology research team at Pace University is led by a multidisciplinary group of professors including Sharon Wexler, PhD, RN, and Lin Drury, PhD, RN, with the College of Health Professions; and Jean Coppola, PhD, with the Seidenberg School of Computer Science and Information Systems. Together, they combine computer science and information technology with public health and geriatric nursing expertise along with students who learn through working with providers in New York City such as Mount Sinai Queens Hospital, where Wexler is also on staff. For more information, visit http://www.pace.edu.
About Pilot Health Tech NYC
A program designed to dramatically increase innovation and collaboration within New York City’s health technology sector, Pilot Health Tech NYC is a partnership between New York City Economic Development Corporation (NYCEDC) and Health 2.0 that pilots and advances new health technologies by partnering early-stage companies with key New York City healthcare service organizations and stakeholders. The Pilot program provides a total of $ 1 million annually to fund at least 10 innovative pilot projects in New York City. Now in its second year, the inaugural class of 10 Pilot companies has already raised over $ 150 million in private investment since winning. For more information, please visit http://PilotHealthTechNYC.com.
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Cigna On ?Prompt Pay Discount? Fraud? “Down From $2 Million/Month To $200 Thousand/Month” For A Hospital Pay
Cigna On “Prompt Pay Discount” Fraud? “Down From $ 2 Million/Month To $ 200 Thousand/Month” For A Hospital Pay
Hanover Park, IL (PRWEB) January 27, 2012
ERISAclaim.com offers webinars to examine the latest federal court development in an ERISA lawsuit between CIGNA and an out-of-network (OON) hospital, with $ 20 million UCR claim by a hospital and a claim for alleged multi-million dollar prompt pay discount fraud (“fee forgiving”) by Cigna. After the court permitted the hospital’s claim to proceed against Cigna on 03/02/2011, Cigna counter sued the Hospital with a fraud claim against the hospital, under a Cigna antifraud “fee forgiving protocol” to reduce the hospital pay “down from $ 2 million/month to $ 200 thousand/month”. While the Court has yet ruled on the merits of all claims by either party, the court documents show that Cigna has been fully implementing the new “fee forgiving protocol” as an antifraud initiative to deny all out-of-network provider claims, including the alleged “prompt pay discount” fraud.
The Court Case Info: North Cypress Medical Center Operating Co., Ltd. et al v. Cigna Healthcare et al, Case 4:09-cv-02556, Filed: 08/11/2009, United States District Court Southern District of Texas Houston Division.
ERISAclaim.com offers in-depth analysis and timely Court-Watch on this case, as this “ERISA v Discount Fraud” court battle will likely represent the No. 1 health claim denial nationwide for all OON patient and provider claims for 2012, especially in the deductible seasons. It is impossible that every provider can collect every dollar of deductible and co-insurance from every patient in this economy with recession and unemployment rates, while 77% Insured Americans paid for out-of-network coverage in private sectors.
“Cigna will deny ALL OON Claims “in total” with ‘fee forgiving’, while no provider can collect 100% from every patient 100% of the time, therefore this Court case is for every OON patient and provider in USA,” says Dr. Jin Zhou, President of ERISAclaim.com, a national expert on PPACA and ERISA appeals and compliance.
(http://www.cigna.com/health/provider/medical/forms/pdf/Participant_disclosure_form.pdf)
ERISAclaim.com will also discuss compliant proactive ERISA discount practices and ERISA / PPACA appeals for all claims denials and delays.
According to the Court documents, on March 2, 2011, the federal court permitted the hospital’s ERISA lawsuit to proceed.
According to the Court Document, on November 17, 2007, CIGNA filed a counter-lawsuit against the hospital for alleged “prompt pay discount” (“fee forgiving”) fraud, among other things, as a part of its defense, in the Court:
“This action arises from an ongoing scheme by NCMC to defraud CIGNA through a practice known as “fee forgiving.”
“NCMC’s so-called business model wrecks these incentives. Instead of collecting the co-insurance from CIGNA plan members that their plans require them to pay, NCMC waives those payments. NCMC tells CIGNA plan members that it will bill them as if they were seeing an in-network provider, eliminating any financial difference to the member between using NCMC and using another provider in CIGNA’s network. On top of this, NCMC offers these plan members over-the-top “hotel-like accommodations,” unlike those in any traditional hospital, including “all private patient suites with upscale room accommodations, including trim, flat screen televisions, private baths, and wireless internet.”
“Defendants deny the allegations of the third sentence of paragraph 30, except admit that one CIGNA employee wrote an email on or around February 18, 2009 that stated in part “spend at North Cypress Medical Center has come down from $ 2 million/month to $ 200 thousand/month so all of our hard work is paying off and the pressure is being felt by the physicians in the area as well as NCMC, which is a good thing;” Defendants respectfully refer the Court to that email.”
On December 14, 2011, the plaintiff hospital filed a motion to dismiss CIGNA counterclaim, asserting ERISA preemption.
On Jan 11, 2012, the defendant Cigna filed defendants’ response in opposition to plaintiffs’ motion to dismiss defendants’ counterclaims.
According to Cigna Website, Cigna will deny all OON claims “in total” with “fee forgiving”, including “prompt pay discount” (http://www.cigna.com/health/provider/medical/forms/pdf/Participant_disclosure_form.pdf):
“Notice to Participant regarding “fee forgiving” by providers that do not participate in the CIGNA HealthCare network.
Some non-participating providers may offer to waive the amount that you are obligated to pay when you use your out of network benefits by stating that that they will “accept what insurance pays as payment in full.” This conduct may impact your benefit claim. The amount waived may adversely affect the amount of the benefit under your plan. Claims submitted by providers that engage in fee forgiving may be denied in total or you may be required to pay the non-participating provider and then file a claim for reimbursement.
If a non-participating provider offers to waive or forgive any part its charges, please notify the CIGNA HealthCare Special Investigations Hotline at 1.800.667.7145”
To find out more about PPACA Claims and Appeals Compliance Services from ERISAclaim.com:
http://www.erisaclaim.com/products.htm
Located in a Chicago suburb in Illinois, for over 12 years, ERISAclaim.com is the only ERISA & PPACA consulting, publishing and website resource for healthcare providers in the country. ERISAclaim.com offers free webinars, basic and advanced educational seminars and on-site claims specialist certification programs for doctors, hospitals and commercial companies, as well as numerous pending national ERISA class action litigation support. Dr. Jin Zhou is regarded as the industry “Godfather of ERISA claims” for healthcare providers.
For any questions, please contact Dr. Jin Zhou, president of ERISAclaim.com, at 630-808-7237.
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©Copyright 1997-
, Vocus PRW Holdings, LLC.
Vocus, PRWeb, and Publicity Wire are trademarks or registered trademarks of Vocus, Inc. or Vocus PRW Holdings, LLC.