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 alphalyticsinfo@alpha-sys.com or call 800-732-9644.

  • Reveal trends that can be used to negotiate and manage payer behavior more effectively
  • Trended analysis into collection of contracted revenue
  • Compare financial performance of comparable payer plans against each other
  • Validate accuracy of your contract management application without running any reports

As a Managed Care leader, you negotiate contracts with specific revenue expectations in mind. You expect payers to live up to their end of the contract to pay for services provided. You want to pinpoint the service lines where your organization is not achieving its contracted revenue. You also want to ensure that your contract management application is valuing accounts properly so that your contract revenue is stated accurately.

Alphalytics will spotlight the areas where you are not achieving your contracted revenue, and trend the delta between expected and actual reimbursement. Take like-payers and compare/contrast how they pay, when they pay, and their initial pay/denial metrics to get you that payer performance scorecard you have been seeking.