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Denials Prevention and Management with RevTrack

Denials Prevention and Management with RevTrack

Denials Prevention and Management with RevTrack

By Sift Healthcare

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Overview


Select which hospital or health system you work at and see a personalized match score.
About

DESCRIPTION

Prevent denials with advanced claim edit support, increase likelihood and speed of overturn with AI-based recommendations driven directly into your workflow. Gain insight with advanced analytics.

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CLIENTS OVERVIEW
Key Clients
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USED BY
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EHR integration

Integrations:

Acute care EMR, Ambulatory EMR, Access +/or revenue cycle

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

Allscripts, Cerner, CPSI, eClinicalWorks, Epic, Other

Hardware Compatibility:

Desktop, Other

Description

A data science and AI-powered denials management solution that integrates with our client's existing workflow tool(s) with a two-pronged approach, both preventing denials and managing them efficiently through AI-based prioritization. There are two options available for clients, one that includes a best in breed clearinghouse and one that can be deployed with a client’s existing clearinghouse. If the client adopts the full solution including clearinghouse, unlimited edits are included and added within the system. If a client chooses to continue using their legacy clearinghouse, Sift's solution functions as follows: Smart claims edits are generated daily for all new claims based on 837 data. Recommended edits that should be in place are clearly prioritized in a dashboard, and alerts can be arranged per client specifications. Denials that are not prevented are also run through a proprietary claim scrubber post-denial to catch additional edits that were not caught “upstream” by the health system’s EHR-based claim edit engine or its clearinghouse, ensuring these denials will be prevented in the future. Denials that persist are then automatically prioritized based on AI-trained models that integrate with existing work queues in the EHR or other workflow tool. Results and team productivity are carefully tracked and provide valuable business insights to revenue cycle leadership.
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Use cases

Description

None provided

COVID-19 use cases:
With the changing payer mix and documentation and coding challenges during a time when higher margin elective procedures have disappeared and patients are even less able to pay balances due, turning receivables into cash as efficiently as possible is more important than ever. Payer specific claim edits updated daily based on raw claims and denials data (837 and 835) mean higher first pass payment rates. For denials that persist, ensure your teams are laser focused on the denials with the highest value to the organization, the highest likelihood of overturn with significant payment.
Users:
VP of revenue cycle, denials team, revenue integrity team
Differentiators

Differentiators vs Internal Options:

None provided

Differentiators vs Competitors:

None provided

Diversity, equity, and inclusion practices

DEI is short for diversity, equity, and inclusion. Learn more about DEI practices.
Product Design

None provided

Product Delivery

None provided

Company information

Founded in 2017

2.5M total equity funding

About AVIA Connect

AVIA Connect helps healthcare providers make better digital health vendor selections. Our AVIA Connect Marketplace enables digitally focused healthcare providers to search thousands of vendor profiles and match with vendors that meet their requirements.

AVIA Connect is a product of AVIA, the nation's leading digital transformation partner for healthcare organizations.

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