Healthcare

Additional revenue of $40m+ identified annually

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Challenges

One of the largest health systems in the nation, with over $4 billion in net revenue, relied on an inefficient, resource-intensive rules-based revenue cycle system. The low revenue opportunity findings with high false positives and high resource cost led to millions of dollars in lost net revenue due to missed charges and coding errors.

Solutions

RevCaptureAi streamlined the charge reconciliation process and identified potential areas of opportunity. Predictive analytics to identify complex charging patterns and identify missed charges at account level for both hospital and professional charges. Fully automated integration with a variety of EMR systems in different regions. Leverage feedback models to learn from auditor’s responses and make intelligent predictions.

Outcomes

$40M+
confirmed missed charges
100%
outpatient accounts analyzed
Identified top departments with gaps in charge capture

$40m+ confirmed missed charges. 100% of outpatient accounts analyzed through automated pre-bill and post bill process. Identified top departments/areas with systemic gaps in charge capture e.g., Injection/Infusions, EKG, surgery, implants & medical devices.