CONNECT by Zimmet Healthcare

Regulatory Reimbursement Management (“RRM”) grows more complex for Skilled Nursing providers each year. From admission through Medicare and Medicaid PDPM management, quality reporting incentives, and post-discharge hospitalization monitoring, Zimmet Healthcare’s CONNECT suite supports reimbursement, compliance, efficiency, and decision-making. With 35 years of experience, we understand that providers face unique challenges, so we made customization a standard feature.

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Partner's Customer Authorization form to Marketplace

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My company currently uses this partner’s solution or works with a party that uses the this partner’s solution and I would like to integrate it with our MatrixCare EHR(Required)

Yes

Is your EHR Implementation in progress?

Yes

Consent to Share Data, including Patient Information between MatrixCare and the Partner Company is the company proposing this Authorization. Company has built an Integration to be able to populate data from your database(s) and/or from a static copy of your database(s) (including all facilities in an enterprise account) in the MatrixCare, Inc. ("MC") Solution that is updated from time to time, and, if applicable, bidirectionally. It is our policy to obtain consent from each of our customers before we allow their data to be shared with another company or party. We have a Business Associate Agreement in place with you, and we have been informed by MC that they also have a Business Associate Agreement in place with you for the protection of that information.

Please complete all the fields below and submit this Authorization form authorizing us to exchange data between MC and Company.

By submitting this Authorization, I, as a duly authorized representative of the Client/Customer, hereby grant my consent to the passage of data between the MC Solution and the Company Solution and represent and warrant that Customer is legally free to enter into this Authorization.

About you:(Required)

First Last

MatrixCare EHR URL(Required)

Your company information:(Required)

Company Requesting This Integration Your Job Title

Your Company email Address(Required)

Your Phone(Required)

Facility information for Integrations:

Click here for Customer Authorization Form FAQs to help with completing this form.

PLEASE NOTE: You can individually add in the Facility information in the form below [Click the (+) to add multiple locations or care settings]

OR Upload a document with the facilities information. Please refer to this document for the specific formatting.

List all facilities requesting Integration

Facility Name

Facility Address

MC ID

Care Setting

ALTERNATIVELY : Upload File or list below

Upload file containing all facilities requesting Integration

Accepted file types: pdf, xls, xlsx, doc, Max. file size: 50 MB.

Comments

CMI Connect is configured for each State’s unique case-mix system, providing detailed tracking and medical record based alerts pre MDS assessment completion.

Quality Connect detects Quality Measure triggers prior to assessment completion and are configured for both Five Star and each state’s unique quality incentive program.

PDPM Connect includes pre-check functionality, identifying reimbursement acuity from hospital admission paperwork, then follows the resident through the Medicare journey alerting the MDS team of PDPM sensitive items both pre-MDS and afterwards for possible IPA completion.