Denials Management Analytics

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

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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

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, including our clients, this solution is designed to facilitate data-driven denials management optimization.  The result? Fewer denials, improved overturn rates and reduced costs to collect.

To make it even more valuable, DenialFlo™, our advanced worklisting solution, optimizes the assignment of your denials inventory to maximize work output from your staff and vendors. The result? It’s like discovering overlooked pockets of cash in your A/R portfolio.

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.

Denials Management Tailored Visual Insights

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.

Denials Management Inventory Breakdown

Denials inventory breakdowns

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.

Denials Management Outliers

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.

Denials Management Root Cause

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.

denials-worklist

Detailed worklisting

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

See why we say You'll see.®