Workflow optimization requires specialized predictive analytics

Our portfolio of predictive analytics are designed specifically for healthcare — built and tested from the experience of hundreds of hospitals and health systems.   The models are integrated to the workflow where resource investment decisions occur.  Teams conserve effort where there is no return.  Intelligent segmentation directs activity follow-up for each patient to the work environment most suited for success. None of the predictive models utilize credit files, so there are no soft hits at credit bureaus. Each predictive analytic provides very broad coverage.

  • Patient-Pay – Next generation propensity-to-pay models that focus on the combination of expected cash value and patient engagement. Applicable for both uninsured and BAI.
  • Eligibility and Charity – Identify patients, either uninsured or underinsured with high patient responsibility, likely to qualify for financial assistance or charity treatment.  Applicable early in the process for eligibility prioritization or late cycle for presumptive charity qualification.
  • Commercial Claims – Move beyond simple age and balance sorting for commercial claims.  The suite of models automates statusing, denial and underpayment efforts based on expected impact on cash recovery relative to work investment.
  • Vendor Placement Optimize vendor placement strategies based upon demonstrated performance not simple alpha-splits, balance-splits or aging. Each vendor receives the accounts where they are the best suited to resolve successfully.
  • Care Management – Models that predict patient’s stability and risk based on their socio-demographics and what happens when home.  Use in combination with clinical analytics and evidence-based protocols to maximize outcomes.

Simply giving your business office employees access to a predictive analytic number does not produce process optimization.  Success comes only when the analytics are embedded in workflow and lead to segmented follow-up where effort matches the need.

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