Toney HealthCare, QualMetrix Announce Solution to Enhance Patient Care Quality while Improving Medical Necessity and Clinical Documentation

Tuesday, March 13, 2018 Clinical Trials News
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TAMPA, Fla., March 13, 2018 /PRNewswire/ -- Toney HealthCare Consulting (THCC), a clinically-oriented consultancy,

and QualMetrix, a healthcare data informatics company, today announced a turnkey data-driven operations platform that ensures patient care is aptly and optimally provided, documented and reimbursed.

By coupling QualMetrix's data platform

with THCC's clinical documentation improvement system, inpatient facilities and ambulatory providers can identify opportunities and assure that appropriate care is provided to their patients and documented accordingly. Structured, technology-enabled, clinical record reviews, conducted in real time, assist providers in identifying gaps in care delivery and documentation. Accurate documentation assists providers in conveying medical necessity, disease burden and patient risk, ultimately leading to correct payment for their services and reducing malpractice risk. At the same time, it assures payers that they are compensating providers appropriately.

"The collaboration with Toney HealthCare allows us to close the loop. Not only can we now identify opportunities and outliers and measure performance for our clients, we can now execute on the information generated on their behalf," said Lawrence Schimmel, M.D., Chief Medical Officer of QualMetrix. 

"Our relationship with QualMetrix allows us to generate quality, resource and financial information for clients and improve documentation," said Sam Toney, M.D., CEO of Toney Healthcare. "This enables providers to ensure quality care, optimize third party payer reimbursement and accurately portray the risk associated with those patients assigned to them."

The integrated approach empowers customers to produce clinical quality, resource utilization and financial information as well as third party payment patterns that can be segmented in myriad ways including by: payer, line of business, diagnosis, procedure code, individual practitioner and individual patient. This enables providers to specifically target the most fruitful opportunities such as claims denials by a certain payer for a certain procedure due to insufficient documentation.

About Toney HealthCare ConsultingToney HealthCare Consulting (THCC) is a leading, clinically-oriented consulting firm providing services in strategy, compliance, management and clinical operations for healthcare organizations. The team of over 140 consultants includes nationally recognized subject matter experts across the spectrum of the healthcare industry who, through years of hands-on experience, have in-depth understanding of the issues that impact performance and organizational success. Our mission is to enable our clients to realize their fullest potential and attain sustainable success by sharing knowledge, developing leaders and collaborating on the implementation of innovative, enterprise-focused strategies. Headquartered in Tampa, FL, THCC serves clients nationwide. For more information, visit

About QualMetrix QualMetrix is an outcome-driven healthcare analytics provider enabling connected intelligence across the care continuum by transforming massive amounts of data into actionable insights.  The QualMetrix platform was created by health care professionals so that organizations of any size could manage their cost and utilization, quality initiatives, population health, provider performance and HEDIS to improve both quality of care and cost of care.  The easy identification of outliers, opportunities, and the ability to measure performance are key to the success of any organization and QualMetrix enables that to happen.  For any additional information please go to

Media Contacts:Mike MiniatiToney HealthCare 813.777.6552

Michelle 844.429.0541

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SOURCE Toney HealthCare

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