Predictive Analytics

A powerful solution for CFOs/Revenue Cycle Leaders determined to enhance net revenue and cash flow.


PROBLEM: Denials and Underpayments

Every day, the stakes get higher – but the “solution” remains the same. The challenge of bundled payments and re-admission rates is increasing billing complexity and denials. Underpayment has become so commonplace it is assumed. Denial patterns have become increasingly impenetrable. ICD-10 is poised to usher in an entirely new class of billing mistakes. In this environment, CFOs/Revenue Cycle Leaders are being judged by their ability to recover revenue and accelerate cash flow.

The problem: The traditional means of dealing with such new realities doesn’t work. Throwing staff and spreadsheets at challenges like these is tried but not true. By the time you get the numbers, they’re yesterday’s news. All this is occurring within a system that is all about the next claim. As a result, you’ve been forced to accept untenable levels of underpayment and denials as the cost of doing business.

SOLUTION: Alphalytics™ for Denials Prediction and Revenue Risk Mitigation  A

Alphalytics impacts organizations across many departments. Click below to read more on how they are positively affected. For more information, contact or call 800-732-9644.

Alphalytics is a quick to deploy Software-as-a-Service (SaaS) solution designed specifically to pinpoint denials-driven revenue risk and predict future revenue leakage thereby enabling visibility into the root causes of denials to prevent them from re-occurring, and ultimately to recover/ prevent lost revenue. Unlike other revenue cycle analytics that are based solely on traditional historic business intelligence, Alphalytics uses advanced predictive analytics to uncover hidden revenue risks that otherwise go undiscovered.

• Predicts where denials are likely to occur next so you can drive the operational change needed to reduce denial rates
• Quantifies the top denial patterns by payer with drill down capability to the claim and remit level
• Provides transparency into denial overturn rates and associated time lags
• Trends initial claim submissions and attain partial-pay and no-pay denial rates
• Aggregate disparate data streams into one analytic application that delivers the revenue cycle decision support needed in today’s climate
• Benchmarks your payers and benchmarks you to your peers
• Delivers immediate benefits to the CFO and each member of revenue cycle leadership team (see diagram and tabs)
• Secure, scalable, web-based, Software-as-a-Service (SaaS) solution that is rapidly adaptable to the unique needs and priorities of each healthcare provider, requires no incremental IT investment and is priced with fixed monthly fees over a 36 month term that align with monthly operational budgets (no capital investment).

Value Summary Example: