Hospital Systems &
Health Care Delivery Networks
Healthcare RCM, Consulting and BPO Firms
Who we serve
Healthcare systems are feeling the strain of a complicated and cumbersome reimbursement process. Even with the most recent technology, organizations suffer from missing charges, claim denials and other threats to their revenue. Often, mountains of disparate operational, clinical and financial data hinders RCM efficiency and are the source of persistent high labor costs and revenue shortfalls.
We design an all-in-one platform that analyzes every relevant clinical and financial piece of data, including all locations and operating systems, and creates a customized, automated response ‘alert’ to deviations that cause revenue challenges and denials. Our solution advises, guides and automates the fix to problems before claims are generated, avoiding denials and their impact on the bottom line.
Our technology sits like an umbrella over your entire revenue cycle. It is an exception-based, actionable analytics reporting framework that collects, reconciles and evaluates disparate amounts of data out of any current transactional system – no matter the size, data incompatibility or platform complexity. Exception-based triggers identify deviations from norms, allowing organizations to reduce errors, improve productivity, meet compliance requirements and ensure financial viability.
Effy Proactively Improves Revenue Cycle Performance
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Define the variance and trigger alarms. Drill down to analyze and detect problems. Find opportunities to improve revenue capture, minimize audit risk, ensure regulatory compliance, and measure and monitor the impact of coding on revenue.
Capture, collect, reconcile and analyze data out of all systems and monitor customized billing rules to ensure accuracy. Virtually any metric can be monitored and used as an alarm trigger including missing or incompatible information, coding errors and expired authorizations. After adjudication, monitoring can include underpayments and secondary claims processes.
Tackle clinical, financial and operational inefficiencies through an integrated case management workflow tool that will help follow-up with issues detected and the fixing process. Ensure corrective actions have been taken and continue monitoring.
Stop Revenue Leakages. Reduce Waste. Improve Bottom Line.
According to benchmarks from global management consulting firms*, healthcare organizations can have revenue leakages between 5% to 10% of total revenues, making healthcare one of the industries with the highest rates in the market!
With Effy Healthcare, increase overall collections and
recover at least 50% of potentially lost revenue!
*Source: PWC & BCG Analysis