MSO Data Analytics Software

Our flagship product, the Physicians Analytics software, is a dynamic reporting application for MSOs that uses sophisticated logic and algorithms to facilitate the monthly claims review process. Our industry-leading software identifies claims processing issues that can negatively impact the physician practices and the overall MSO’s financial performance.

Risk Adjustment Factors Analytics

For coders, the push toward value-based care and the HCC payment model have increased the significance of coding accurately and thoroughly. The coding of chronic conditions is not only used in determining healthcare outcomes, but they are also driving costs and, ultimately, reimbursement.

If your practice is receiving reduced funding due to incorrect Risk Adjustment Factors and receiving significantly lower funding, we can assist. 

Our sophisticated algorithms can analyze your claims data and determine whether the correct diagnosis and HCCs have been used to calculate the RAF assigned to your members.

Don’t wait to receive reduced funding and act proactively. Inquire for a full analysis of your member’s claims data.

Medical Economics Consulting

Medical claims data analysis can provide the insights to help your practice focus on providing the best quality of care and produce better outcomes. The analysis of your members demographics, medical, pharmacy and lab claims data using our proprietary technology and big-data analytics tools can help identify cost drivers and predict future outcomes.

Denied Claims Analysis Service

When each claim costs $25 to rework, it pays to get them right the first time. For health systems, hospitals, physician groups, and pharmacies, inefficiencies in claims management not only erode revenue and crush staff productivity but also represent a source of major worry for patients, leaving consumer loyalty hanging in the balance.

Rejection and denial of claims need to be tracked very carefully to ensure they are reprocessed quickly for resubmission and payment. 

Identifying root causes of denials, prioritizing remediation where it is most needed, and leveraging technology are all strategies healthcare providers should be considering when aiming to reduce claim denial rates.

Our 835 EDI algorithms identify claims billing errors that can be permanently corrected to enhance and improve your practice reimbursement capabilities.