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Harnessing the Power of Predictive Analytics to Drive Cash Flow

Posted by Meduit RCM on Feb 26, 2020 3:31:45 PM

Revenue is the lifeblood of any healthcare organization. When it comes to identifying potential payer issues, patient propensity to pay and patients likely to qualify for charity programs, predictive analytics is an excellent tool to help providers prioritize work and optimize limited human resources.

iStock-1150199386That is why Meduit has launched a new suite of solutions called MedProveTM that leverages predictive analytics combined with AI to support providers’ needs, and includes:

  • MedProveTM Patient
  • MedProveTM Payer
  • MedProveTM Charity

MedProve Patient extracts patient account history from the provider’s unique client base, matches it with publicly available data sources and models the patient history of paying bills over time to predict who is sure to pay, who will never pay and who needs a call to nudge them to pay. MedProve Patient can also analyze patients who qualify for Medicaid or charity to identify which are more likely to be accepted and identifies the probability that a patient has third-party liability coverage.

Through predictive modeling, MedProve Patient helps lower a provider’s operating costs by understanding when to eliminate or reduce calls or letters and when to increase contingency recoveries by applying extra efforts on certain patients. The results are accelerated cash flow and reduced A/R days.

MedProve Payer assesses a hospital's A/R based on payer and past history of payments and claim rejections on each type of account to identify preventative actions that eliminate costly rebills and rework. MedProve Payer analyzes denials history from payers to identify patterns of payment delays and can predict whether a claim will be paid cleanly.

By predicting the probability of if (and when) a payer will pay, MedProve Payer helps lower the provider’s operating costs by identifying how the provider can intervene with a claim before the payer can delay or deny payment. This solution helps providers increase their net revenue by focusing resources efficiently on claims with likely value and accelerate cash flow.

MedProve Charity builds a scoring algorithm based on the provider’s accounts to identify patients most likely to qualify for an organization’s charity programs and/or Medicaid. Using the MedProve Charity scoring model, providers can prioritize which patients to follow-up with and redirect staff time and resources away from patients who cannot qualify. Providers can also record presumptive charity discounts according to their individual policies and procedures.

Through use of predictive analytics fueled by AI, this trio of MedProve solutions drives more efficient processes and cost savings for healthcare providers. Click here to download the product briefs for the MedProve Suite of Solutions:

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