Abstract: Methods and systems for monitoring and managing healthcare performance. The system comprises one or more network interfaces configured to provide access to a network and one or more data processing servers coupled to the one or more network interfaces to enable communication with one or more healthcare manager devices. The one or more data processing servers to execute instructions to receive healthcare data from a plurality of data source devices over the network, extract patient medical data from the received healthcare data, group the patient medical data according to episodes of care, analyze the patient medical data to determine variances, generate prescriptive opportunity scripts to reduce the determined variances, add the prescriptive opportunity scripts to a playbook, and generate output corresponding to the analysis and the playbook to the one or more healthcare manager devices.

Abstract: A system and method for monitoring and managing, in real-time, interactions between a healthcare provider, a patient and an insurer is disclosed. The system and method comprises of a virtual or electronic waiting room. Management and monitoring of patient interactions and transactions is achieved by storing attributes associated with a patient and linking these attributes to a virtual representation of the patient, which may be accessed and manipulated via the electronic or virtual waiting room.

Abstract: A system and method for rapid claim submissions by healthcare providers is disclosed. The system and method utilizes middleware applications to obtain point of service adjudications of healthcare claims. A polling procedure that tests middleware and claim engine availability ensures that transactions are carried out in a seamless manner and real-time updates are provided to the healthcare provider.