Innovaccer Launches Denial Prevention and Recovery Accelerator to Revolutionize Revenue Integrity for Suppliers
Today, Innovaccer Inc., the Health Cloud company, unveiled its Denial Prevention and Recovery Accelerator, the latest addition to the company’s Revenue AI suite of vendor-neutral solutions that help vendors rapidly improve the revenue cycle – in as little as six weeks – to significantly improve their financial performance.
Unlike RCM point solutions, Innovaccer’s Prevention and Recovery Accelerator starts by using the power of Innovaccer® Health Cloud, the #1 healthcare data and analytics platform according to KLAS, to ingest, normalize, harmonize and activate data from all available sources that can influence RCM performance. This includes EHRs, referrals and authorizations, other RCM applications, clearinghouses, health plans, practice management, EDI, unstructured data sources and more.
The resulting unified patient record provides a single source of clinical and financial truth about the patient that eliminates the information gaps that exist in virtually all RCM operations. This gives Denial Prevention and Recovery Accelerator’s advanced analysis algorithms the most comprehensive claims information to analyze and use. Now, with unparalleled accuracy, providers can minimize revenue loss from missed fee entry, avoidable denials, payment discrepancies, missed filing deadlines, gaps in clinical documentation, and a myriad of issues. other common issues, challenges, and “gotchas” that regularly damage the integrity of the revenue cycle.
“Machine learning and even rule-based systems are only as good as the scope and quality of data the algorithms have to work with,” said Kanav Hasija, co-founder and chief product officer at Innovaccer. “We’re starting with the industry’s most comprehensive data aggregation platform to provide vendors with unified, high-quality records that eliminate the data silos and fragmentation that impede their efforts to improve the revenue cycle. The result is that our Denial Prevention and Recovery Accelerator is simply unmatched in its ability to help providers reduce and manage denials, payment discrepancies, missed charges, and a host of other issues that ultimately account, can have a dramatic impact. impact on revenue integrity.
According to the Healthcare Financial Management Association (HFMA), up to 90% of all denials are preventable, yet claim denials continue to cause significant revenue losses for providers. Of a total of $3 trillion in claims submitted by healthcare organizations, $262 billion were denied, which translates to nearly $5 million in denials, on average, per provider. Additionally, up to 65% of denied claims are never resubmitted or appealed.
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Innovaccer’s Denial Prevention and Recovery Accelerator helps vendors anticipate this issue with a host of revenue-enhancing features:
- Improve the efficiency of front-end, mid-cycle and back-end processes in just six weeks.
- Delivers 2-4x return on investment in the first year, with improved charging integrity and optimized billing workflow.
- Provides approximately 98% first-pass clean claim rate with denial predictions (pre-bill changes based on payer policies). Rejection predictions are based on historical complaints and pattern recognition, and converted to pre-billing changes from current rejections.
- A centralized workbench monitors and manages denials in one place, with integrated workflow management and customizable revenue intelligence dashboards to monitor denial trends, identify root causes, and provide denial codes. potential grounds for refusals.
- Offers DRG transfer request alerts based on Post-Acute Care Transfer (PACT) rules for potential underpayments, and automatically alerts of any underpayments or overpayments.
- Reduce unnecessary follow-ups by up to 90%; and identifies potentially missed billable charges, tailored to each health system’s billing methodology and industry best practices.
- Helps decipher denials accurately, prioritize and resubmit them faster (with prescriptive recommendations for fixes), and reduce lost revenue due to resubmission delays or missed deadlines.
- And much more.
The result of these comprehensive, integrated capabilities: reduced claim denial rates, a streamlined appeals process, less administrative overhead, and improved speed to revenue.
“Health systems are losing revenue due to factors such as siled data, missed charge capture, increased denials, and lack of transparency and collaboration throughout the process,” said Brian Gray, director Principal, Revenue AI Product Innovation at Innovaccer. “By unifying the revenue cycle, we’re able to deliver a truly unique solution that can leverage the full breadth of clinical and financial patient data and use it intelligently to bridge the computing and analytics gaps in RCM so providers can optimize revenue capture. This comprehensive solution leverages our unparalleled expertise in data unification and activation to help providers better manage claims and get paid more, faster.
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