Denials Management Analytics

The best way to look at denials is when they’re overturned.

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The way we see it, every open claim over 45 days old is a defect. And attacking them one at a time is no solution at all. So we’ve designed our Denials Management Analytics to make the root causes that underlie entire groups of denials crystal clear. Created by leading industry subject matter experts, this comprehensive solution categorizes denials to fit the unique requirements of your enterprise. It pushes outliers and anomalies to the surface as alerts that can trigger immediate response.

To make it even more valuable, DenialFlo™, our prescriptive workflow and worklisting solution, lets users move denied claims to the person who can best overturn denials. The result? It’s like discovering overlooked pockets of cash in your A/R portfolio.

Our approach to denial resolution is bound to deep longitudinal patient analytics. This lets our clients see the root causes that underlie every part of a claim at the atomic level, from beginning to end.

– Keith Eggert, FHFMA
EVP & General Manager, Healthcare
VisiQuate

Key Features & Benefits

Think macro; act micro.

We didn’t design this solution to zoom from 30,000 feet to a single account because it looks cool in a demo; we did it because it works. Besides giving managers a satellite view of the battlefield, this solution delivers progressively granular views that include denial rate trending by facility, service line, payer, department, and down to one single coder. The example below is just one of thousands, but it should give you a good idea of how this solution works.

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Tailored Visual Insights

VisiQuate tailors visual insights to the needs of users in each key area who are responsible for overturning denials. We deliver infographics, location analytics, scorecards and other key visual insights. All widgets are interactive, with easy access to deeper detail to drive actionability.

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Root Cause Heat Maps

There are any number of ways to look at accountable areas of denial: by facility, service area, revenue cycle function, payer, team, and more. We give you the flexibility to set dynamic thresholds that identify opportunities for improvement in all those areas. And this is a multi-layered visualization, so you can see more heat behind the heat, more insights behind the insights.

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Outliers and Anomalies

It’s never been easier to identify the vital few, even when they are constantly changing. Our visualizations make the outliers, anomalies and key risk segments jump off the screen so you can take quick, decisive action.

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Root Cause by Accountable Area

Imagine how effective overturns would be if every penny of every denied claim were tied to an identifiable underlying root cause. That is exactly what this solution gives you.

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Detailed Worklisting

Since the whole idea is to move the needle, DenialFLO™, our prescriptive worklisting engine, prioritizes denials, and assigns each to the person who is best qualified to overturn it.

See why we say You'll see.®