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Healthcare Analytics Solutions

One of the Momentum applications to healthcare analytics is to determine the gap between the amount of revenue hospital/providers are entitled to and the amount of reimbursement eventually received.

Missed charges on patient invoices have a major impact on hospital systems’ results. The proposed system will analyze hospital data using latest big data technology and machine learning to identify revenue leakages and provide actionable insights.

Predictive and comparative analytics have the potential to drive improved value by determining areas where proactive steps can better support optimal revenue cycle performance.

The following healthcare analytics have been developed for various healthcare analytics organizations:

 

Healthcare Analytics Solutions

Insurance claim rejection/denial rates and their causal analysis

  • Causes of rejections/denial
  • Rejections by providers, service categories, employees who prepare bills, by period etc.
 

Analytics to determine un-collected revenues and underpayments

  • Causes of no collections/ underpayment
  • Analysis by various categories and factors that influence underpayment and non-collections

Analytics to determine Revenue at Risk (RAR)

  • Current and future risk of revenue and factors that influence that
 

Charge master analytics to determine invalid and outdated charges

  • Analyze to determine the last update date of each charge
  • Determine charges that are outdated
  • Code optimization

Healthcare Analytics Solutions

Missed charges due to services not coded but available elsewhere within the patient record

  • Determine services that are not coded but available elsewhere within patient records
  • Loss due to such non-coded services
  • Loss by providers, service categories etc
 

Revenue leakage due to non-payment of co-pays

  • Co-pay non-payment analysis by patient age group, service categories, providers
  • Revenue loss analysis

Revenue leakage due to write-offs

  • Write off analysis by service categories
  • Write off reason analysis
 

Other analytics

  • Missing Referral
  • Untimely Filing
  • Missing Authorization
  • Not a Covered Benefit
  • Ineligible on Date of Service

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  • Home
  • Big Data
    • Momentum
    • IoT
  • Analytics Solutions
    • Healthcare
    • Telecom
    • Retail
    • Social Media
  • About Us
    • The Company
    • The Team
  • Customers
  • Partners
  • Contact Us