like Claim Denials, Charge Capture, Medicare Compliance and more
Hospitals lose approximately $262 billion per year on denied claims from insurers, sparking huge cash-flow issues and recovery costs, according to data. Payers initially deny about 9% of hospital claims, putting about $5 million in payments per hospital at risk. Although hospitals ultimately will secure payment for 63% of initially denied claims, it costs $118 per claim on average to recoup the money, not to mention the cost to hospitals of foregoing the payments while they attempt to claim the funds.
This is just an example of a huge revenue leakage hospitals face every day across the country.
EFFY Healthcare’s Business Assurance and Efficiency solution uses continuous, real-time or near real-time data auditing and customized, exception-based triggers to notify staff of costly deviations across key revenue cycle, Medicare compliance, and clinical information that would otherwise impact on denials and other revenue
leakages down the road.
Real-time alerts are triggered any time a data set moves within an unacceptable range and each intervention is recorded, facilitating sustainable, long-term performance improvement.