EXL’s Post

Turning Lemons to Lemonade: Advanced Claims Analytics with Big Data - As payers face the challenges of increased competition and member satisfaction, the ability to execute highly effective claims management has become critical for success. https://lnkd.in/eCrGRrAb

Turning Lemons to Lemonade: Advanced #ClaimsAnalytics with #BigData - As #payers face the challenges of increased competition and member satisfaction, the ability to execute highly effective #claimsmanagement has become critical for success.

Sam: Agree with you 100%, and will add that Scalable Health's vision and capability to drive successful technology partnerships in "Advanced Claims Analytics with Big Data" also competitively positions Providers, Integrated Provider Networks and Health Plans to build the foundation to advance numerous healthcare opportunities, just to name a few: 1) Driving performance results for Joint Operating Committee's (Health plan and Provider VBC Teams) 2) Strengthen decision making capabilities and savings from Medical Evaluation Review (MER) 3) Escalation of Quality and STARs Reporting Improvement results 4) Advance the integration and interoperability of claims data 5) Capture key member engagement and quality care outcomes Scalable Health is healthcare's answer to improving and changing the way healthcare is delivered Ruben Chief Healthcare Innovation & Improvement Officer, Scalable Health

Exciting news from #AHIP2024! We're debuting our end-to-end data management solutions for #payers at booth #1727. Our innovative automation is helping payers #credential 60% more providers, 30% faster. Learn how we're driving better member outcomes!

Well, this is fabulous news and wise words from Vikas on the last slide.

One survey showed the top 3 reasons for an increase in claim denials were insufficient data analytics (62%), lack of automation in the claims/denial process (61%), and lack of thorough training (46%). 📈 When resources are spread thin for revenue integrity teams, strategic and customized insights are necessary to ensure accurate reimbursement and billing compliance. Here are 6 claim denial reports for your revenue integrity teams to leverage. 💪 Head to our blog to read more 👇 https://hubs.ly/Q02tnf4q0 #mdaudit #claimdenials #revenueintegrity #denialrecovery #denialmanagement

Financial clearance stands as a vital shield against financial risks, ensuring payment commitments from payers and patients, and shaping a robust revenue cycle. Yet, the challenge persists for provider organizations to secure appointments ahead of visits due to staffing, technological, and operational constraints. In 2022, initial denials spiked to 11% of all claims from nearly 8% in 2021, leading to revenue leakage and denting patient experience scores. Overcoming these hurdles is pivotal to streamlining operations and enhancing the revenue cycle's resilience. Read more here: https://lnkd.in/e5HeGb7k #revenuecycle #financialclearance

Denials causes can lurk in many places, including CARC codes, training gaps, changing payer requirements, and error-prone manual processes. Check out our denials playbook for solutions, including ways to optimize your automation and data analytics. Get the playbook today: https://lnkd.in/grcukVDK #revenuecyclemanagement

Seeing gaps in your practice's revenue? 💸 Here are signs you might be facing revenue leakage. Let us help you seal those gaps and optimize your financial health. Strengthen your practice's backbone with our expertise. 🏥💼 - Increased Claim Denials - Inconsistent Cash Flow - Outdated Billing Systems - High Patient Receivables #RevenueProtection #MedicalPracticeInsights #RCM #RevenueOptimization #MedicalPractice #RevenueBoost #FinancialStrategies #CodexMedical

With frequent notices being issued by tax department it is critical to keep a track of same to enable timely compliance. The below technology solution helps do the same in automated manner. This is a brief video on the solution.