Achieve optimal financial yield
Revenue cycle leaders resolve delayed reimbursements from hundreds or even thousands of payors daily. The resources available to complete this task include manual, error-prone processes and an ocean of data with limited visibility. The result: providers receive late payments that don’t meet expectations while revenue leaders risk inaccurate financial reporting and billing.
Our team specializes in RCM yield – meaning we go beyond revenue reimbursement alone. We do this by leveraging analytics and leading technology to proactively prevent revenue cycle problems and optimize your organization’s financial performance.
How we help revenue cycle and HIM teams
Using our data review processes and machine learning, we can help organizations aggregate big data payors rely on to assess care acuity. This encompasses clinical performance metrics, HCCs, quality indicators, present-on-admission indicators and more. As a result, revenue leaders gain deeper insight into and effectively track the different billing processes as well as proficiently manage the financial systems related to patient care and reimbursement.
How we help providers
We use data to address revenue leakage and help providers understand what they should be getting paid based on payer agreements. We utilize process automation to explain reimbursement shortfalls, such as broken workflows, documentation errors and noncompliance with payer agreements, and guide providers on how to prioritize action based on risk. Our insights optimize workflows, eliminate errors and ensure front-end accuracy, expediting reimbursement.
What we do
AI and Machine Learning
Gain a clear understanding of how coding was applied and learn how to correct errors from manual coding efforts.
Robotic Process Automation
Shift from manual to automated intelligent computer coding processes to achieve a more efficient and streamlined process.
Insights through Actionable Data
Identify valuable insights from vast oceans of data to better understand what to take action on and when.
RCM Process Redesign and Transformation
Establish a modern and transparent system with proactive flags to facilitate earlier reviews and interventions.
Risk Calculation and Scoring
Determine reimbursement and workflow gaps and identify risk through relevant data insights.
Data Modeling and Interoperability
Gain visibility across data silos and beyond billable items to incorporate all diagnostic work provided for a comprehensive view of patient history.
Compliance and Payor Submissions
Automate the review of payer agreements and reimbursement processes to identify areas for improvement.
Transform your RCM with expert guidance
Gain access to the top technical minds and the best tools in the industry to maximize reimbursement and offset reduced margins. We’ll guide you through every step as you make important strategic shifts to your RCM.