January 9, 2023

Rx: A Dose of RevCaptureAi for the Healthcare Industry

While the healthcare industry has grown leaps and bounds in delivering advanced medical treatment and care to its patients, it still has a lot of ground to cover in maximizing revenue capture, mitigating missed charges, and improving bottom lines. With the massive growth of digital data, hospitals have invested heavily in products that claim to be powered by Machine Learning (ML) technology. But in reality, they are rule-based and misleading! With a rule-based approach, coupled with audits, the entire revenue cycle system becomes resource-intensive, expensive, and continues to miss charges yet to be identified or codified as rules.

With missed charges being a widespread challenge across the healthcare industry, there’s an urgent need for innovative, cutting-edge products to recover the billions of dollars typically lost yearly. The current state of the healthcare industry, with high costs and limited labor, makes this an opportune time to stop missing legitimate charges. That's where ML can help hospitals look across staggering amounts of data, analyze patterns and look at outliers to deliver extraordinary insights. State-of-the-art technology today allows scanning of the entire revenue cycle, covering administrative and clinical operations that capture and manage patient services revenue. As a result, they navigate the complexities of billings, coding mistakes, insurance claims, payer denials, and the collection process to identify missed charges and plug unnecessary revenue leakages.

At ElectrifAi, we call this Consequential Ai!

RevCaptureAi, the only ML-powered product that captures missed charges in weeks

Yes, that's right! Not months or years, but in 6-8 weeks. RevCaptureAi harnesses the power of ML and AI to analyze data from disparate hospital and physician systems to uncover anomalies and draw insights to maximize revenue capture. It helps achieve operational excellence by identifying potential sources of the leaks and then fine-tuning the processes to avoid such leaks in the future.

No more reinventing the wheel. No more heavy investments from scratch that yield results after several iterations. No more replacing your existing systems with a new one that doesn't guarantee a predictable outcome. RevCaptureAi's pre-built, containerized capabilities make it easy to deploy and can be implemented on-premises or hosted as a service while supporting leading EHR or EMR software. The model prioritizes predictions for revenue realization using payer contract data and historical payments data. Every dollar invested in the product typically yields 8X in return.

What's more—it has an intuitive, modern, and aesthetic user interface, giving a smooth and seamless user experience. Its highly customizable dashboard enables users to access, slice and dice, and analyze data to draw comprehensive, meaningful, and actionable insights to power your operations.

RevCaptureAi: the perfect booster shot for leading global healthcare facilities
  • RevCaptureAi helped a large health system provider, with USD 4 billion in net revenue, streamline their charge reconciliation process and identify potential areas of opportunity. It employed predictive analytics to identify complex charging patterns and locate missed charges at the account level for both hospital and professional accounts. The product identified over USD 40 million in confirmed missed charges annually and analyzed all 100% outpatient accounts through automated pre-bill and post-bill processes. Additionally, it spotted top departments with systemic gaps in charge capture, such as Injection/Infusions, EKG, surgery, implants, and medical devices.
  • A mid-size hospital had limited resources to deal with revenue leakage challenges. The low revenue opportunity findings with high false positives and high resource cost led to millions of dollars in lost net revenue. RevCaptureAi identified billing challenges, adjusted thresholds accordingly, and leveraged its customizable dashboards to offer deep insights into potential problem areas and educate departments. As a result, the hospital captured over USD 14 million in confirmed missed charges, with 100% of outpatient accounts analyzed through automated pre-bill and post-bill processes.
  • A large healthcare services provider, with close to 90 campuses in 30 states and more than USD 5 billion in revenue, had no system to track billing practices or identify missed charges. With only 35 faculty of the 89 utilizing the tool, RevCaptureAi helped the auditors confirm USD 9.7 million of missed charges. The product prioritized daily workload so auditors could confirm and resolve missed charges that yielded the highest returns at the most efficient rate. Not just that—the product enabled 100% of outpatient accounts to be analyzed through automated pre-bill and post-bill processes.

ElectrifAi: US' leading ML products provider

ElectrifAi is one of the US' leading ML products providers, with an extensive library of pre-built ML products enabling our clients to capture tangible benefits quickly. We work with the C-suite to understand and solve business problems through data and machine learning in diverse industries such as Higher Ed, BFSI, Life Sciences, Hospitality, Retail, Chemicals, Oil & Gas, Telecom, Insurance, etc. The insights generated by our ML products, such as ContactCenterAi, ReputationAi, InventoryOptimizationAi, RevCaptureAi and other products, have helped our clients realize consequential business outcomes in 6-8 weeks.

Our product does not require investment in a new platform or infrastructure. Instead, we leverage the data existing in your system to power the ML models to deliver business outcomes.

We are the last-mile product that sits on the top to solve specific business problems and bring about savings. Contact us to learn more!