Care Management
- Predictive daily revenue risk-scoring for prevention of readmissions and level or care downgrades served up and ready for action
- Integrate care management reporting module into larger analytic framework
- Lessen dependency on historical final denial reporting - gain more meaningful perspective from initial denial rates
As a Care Management leader, you want to know the specific data patterns that have historically resulted initial denials due to level of care issues. You also seek denial overturn rates and associated net revenue recovered based on your staff’s efforts. You also want insights on high-denial risk patients that are still in-house.
Alphalytics will empower you with the targeted insights needed to aid you with clinical denial reductions. Historical patterns arm you with the specific types of cases that are being denied, as well as the frequency of the denial and net dollars at stake. Establishing daily risk-scoring will allow focus on cases with data patterns that, based on past experience, serve as a warning sign of a future denial