The healthcare industry faces staff shortages, increased labor costs, and inflation on top of pre-pandemic healthcare affordability and access issues. This accelerating crisis presents an opportunity to reshape the business with data and automation to deliver outstanding care while improving the bottom line.
With the massive growth of digital data, using a rule-based approach coupled with manual audits to flag revenue leaks has proven inadequate. With revenue leakage being a widespread challenge across the healthcare industry, innovative, cutting-edge solutions are needed to recover the billions of dollars typically lost yearly. Machine Learning can look across staggering amounts of data, analyze patterns and look at outliers to deliver extraordinary insights.
State-of-the-art technology today allows scanning the entire revenue cycle, covering administrative and clinical operations that capture and manage patient services revenue. As a result, they navigate the complexities of billings, coding mistakes, insurance claims, payer denials, and the collection process.
Harness the power of pre-built AI and ML solutions to capture missed charges in weeks
Daitix’s pre-built AI and ML solutions have the capability to identify, predict and capture missed charges faster than ever before. Our solutions analyze data from disparate hospital and physician systems to uncover anomalies and draw insights to maximize revenue capture. They help in achieving operational excellence by identifying potential sources of the leaks and then fine-tuning the processes to avoid such leaks in the future.
ML models learn continuously with more and more data and user interaction, leading to higher revenue excellence. Our solutions are easy to deploy and can be implemented on-premises or hosted as a service while supporting leading EHR or EMR software. The pre-built model prioritizes predictions for revenue realization using payer contract data and historical payments data.
One of the largest health systems with over $4 billion in net revenue relied on an inefficient, resource-intensive rules-based system revenue cycle system. The low revenue opportunity findings with high false positives and high resource cost led to millions of dollars in lost net revenue due to missed charges and coding errors.
Daitrix’s pre-built AI and ML solutions streamlined the charge reconciliation process and identified potential areas of opportunity. We used predictive analytics to identify complex charging patterns and locate missed charges at the account level for both hospital and professional accounts.
We automated integration with a variety of EMR systems in different regions. In addition, we leveraged feedback models to learn from auditors’ responses and further enhance the predictions.
Daitrix helped the client identify $40m+ confirmed missed charges annually. We analyzed all 100% outpatient accounts through automated pre-bill and post-bill processes. Additionally, we spotted top departments with systemic gaps in charge capture, e.g., Injection/Infusions, EKG, surgery, implants & medical devices.
Connect with us today to explore how you can harness our cutting-edge solutions to unlock your growth story!
