Automated Patient Access for Orthopedics White Paper

What We Do
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What We Do
- Patient Access
  
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  Patient Access
  Get patients the care they need fast by automating financial clearance and authorizations prior to service.
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  Prior Authorization
  
  Eligibility Verifications & Benefits Checks
  
  Patient Pay Estimates
  
  Insurance Discovery
  
  Patient Access Analytics
  
  Document Capture
  
  Prior Authorization Support For Referring Physicians
  
  Patient Scheduling
- HIM & Medical Coding
  
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  HIM & Medical Coding
  Ensure patient encounters get coded accurately on time with AI, OCR, automation and workforce management leveraged by document capture experts and coding specialists with the right clinical expertise.
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  Medical Coding Support
  
  Clinical Documentation Improvement (CDI)
  
  Provider Credentialing
- Revenue Integrity
  
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  Revenue Integrity
  Convert patient encounters to maximum recoverable revenue by ensuring all possible charges get captured before claims get submitted by leveraging AI, charge auditors, billing specialists and payer compliance experts.
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  Charge Capture Optimization
- Medical Billing
  
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  Medical Billing
  Reduce billing errors and improve cash flow with accurate payment posting and credit balance resolution leveraging billing experts and automations.
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  Payment Posting
  
  Credit Balance Resolution
  
  Soft Patient Collections
- Revenue Acceleration
  
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  Revenue Acceleration
  Accelerate maximum claim reimbursements, overcome denials and reduce future denials with AI, automation, intelligent workflow management, advanced analytics and billing specialists.
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  A/R Recovery & Denials Management
  
  Insurance Discovery
  
  Soft Patient Collections
  
  Appeals Management
  
  Denials Prevention
  
  Revenue Cycle Analytics
- Healthcare Contact Center
  
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  Healthcare Contact Center
  Optimize patient interactions with specialized support for scheduling, patient inquiries, and soft collections to enhance practice efficiency and patient experience.
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  Patient Scheduling
  
  Patient Soft Collections
  
  Patient Service
- Full Service RCM Optimization
  
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  Full Service RCM Optimization
  Need help with it all? Our revenue cycle experts will audit, advise, and optimize your organization's EHR system and revenue cycle workflows so that cash flow improves in a matter of months.
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  RCM Assessment
  
  Revenue Cycle Outsourcing
Revenue Cycle Managed With Intelligence & Automation
Accelerate patient access, improve claim accuracy and charge integrity, reduce denials, and maximize reimbursements with the latest revenue cycle technology leveraged by specialists with RCM, clinical and compliance expertise.
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Our Platform
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Our Platform
- Healthcare Revenue Operating System
  
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  Healthcare Revenue OS
  The Operating System for Healthcare Revenue. Connect systems, automate routine steps, route exceptions with control, and reduce denials, A/R days, and cost to collect.
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  Our Approach
  
  Revenue Cycle Agents
  
  RCM Specialists
  
  Payer Connections
  
  Provider EHR Integrations
  
  Security & Compliance
  
  Workflow Execution
  
  Workforce Orchestration, Human-in-the-Loop
  
  Analytics & Insights
- Revenue Cycle Agents
  
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  Revenue Cycle Agent Platform
  Our Revenue Cycle Agent Platform offers various types of agents from reasoning to mundane execution and human-in-the-loop processes, each designed to tackle unique challenges and bring efficiency, precision, and expertise to your revenue cycle workflows.
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  Our Approach
  
  Agent Catalog
- EHR Provider Integrations
  
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  EMR, EHR, PMS, LIS, RIS Integrations
  Compatible with provider systems using HL7, X12, APIs, RPA and FHIR-ready standards.
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  Allscripts
  
  athenaHealth
  
  Centricity
  
  Cerner
  
  eClinicalWorks
  
  Epic
  
  eRad
  
  Exemplar LIMS
  
  Greenway
  
  Imagine
  
  MedicsPremier
  
  ModMed
  
  NextGen
  
  Open Doctor
  
  Proprietary EMRs
  
  PX Technology
  
  Raintree
  
  Salesforce
  
  Scriptsender
  
  Surgimate
  
  Urochart
- Payer Connections
  
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  Payer, Clearinghouse & Benefit Manager Connections
  2800+ payer connections and growing, spanning eligibility, authorizations, claims, denials, posting, and A/R, with coverage varying by workflow and plan configuration.
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  Evicore
  
  AIM
  
  Availity
  
  Optum
  
  NIA Magellan
  
  HealthHelp
- Security & Compliance
  
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  Security & Compliance
  Health-grade security safeguards to protect PHI across operational workflows.
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  HITRUST
  
  HIPAA
  
  SOC 2 Type II
  
  ISO 27001
- Custom Solutions
  
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  Custom Solutions
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  Our Approach
Our Operating System for Healthcare Revenue
Connect systems, leverage AI for reasoning, automate routine steps, route exceptions to humans with control, to reduce denials, A/R days, and cost to collect.
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Our Solutions
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Our Solutions
- Document Capture Plus
  
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  Document Capture Plus
  Agent suite that intelligently classifies, extracts, and accurately inputs patient data from any document directly into your patient records system—backed by expert support when you need it.
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  Our Approach
- Patient Access Plus
  
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  Patient Access Plus
  Get quicker financial clearance for patients before care with Patient Access Plus that provides complete coverage for obtaining eligibility verifications, benefit checks, patient pay estimates and prior authorization approvals, all in one agent suite.
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  Prior Authorization
  
  Eligibility & Benefits Verification
  
  Patient Pay Estimate
  
  Insurance Discovery
- RCM Plus
  
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  RCM Plus
  Maximize reimbursements from A/R inventory and denied claims, as well as reduce future denials with AI, automation, intelligent workflow management, predictive analytics and billing specialists.
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  Our Approach
Supercharge RCM With Technology
Leverage our agent suites and tech-enabled services maximize reimbursements for your organization.
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Our Agents
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Our Agents
- Revenue Cycle Agent Platform
  
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  Revenue Cycle Agent Platform
  Our Revenue Cycle Agent Platform offers various types of agents from reasoning to mundane execution and human-in-the-loop processes, each designed to tackle unique challenges and bring efficiency, precision, and expertise to your revenue cycle workflows.
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  Revenue Cycle Agent Platform
  
  Agent Catalog
- Agent Catalog
  
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  Agent Catalogs
  Choose from our agent catalog or let us customize one for your unique needs
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  Our Agents
Revenue Cycle Agent Platform
Reasoning plus execution inside Healthcare Revenue OS, AI that decides the next step and automation that completes it.
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Who We Help
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Who We Help
- Specialties
  
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  Tackling RCM Challenges Unique To Specific Specialties
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  Radiology
  
  Cardiology
  
  Pathology
  
  Orthopedic
  
  Gastroenterology
  
  Oncology
  
  Pain Management
  
  Laboratory
  
  Physical Therapy & Occupational Therapy
  
  Behavioral Health
  
  Dental
  
  Durable Medical Equipment (DME)
  
  Ear, Nose & Throat (ENT)
  
  Ophthalmology
  
  Rheumatology
  
  Neurology
  
  OB & GYN
  
  Sleep
  
  Urology
  
  Sports Medicine
  
  Home Health
  
  Infusions & Injections
  
  Long Term Care (LTC) Pharmacy
  
  Medical Device
  
  Pharmacy Benefit Medication
  
  Specialty Drugs
  
  Specialty Pharmacy
  
  Speech Therapy
  
  Wound Care
- Ambulatory Surgery Centers (ASC)
  
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  Ambulatory Surgery Centers (ASC)
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  Our Approach
- Acute Care Hospitals
  
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  Acute Care Hospitals
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  Our Approach
- Rural Hospitals
  
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  Rural Hospitals
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  Our Approach
- Physician Groups
  
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  Physician Groups
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  Our Approach
- LTC Pharmacies
  
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  LTC Pharmacies
  Capture more revenue for your LTC pharmacy with prior authorizations, Rx processing, billing and mail order support.
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  Our Solution
- Dental Practices
  
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  Dental Practices
  Increase dental practice revenue by 20% and reduce overhead by 25% with automation and billing specialists.
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  Our Solution
We Work With All Provider Types & Specialties
We continue to expand our revenue cycle technology platform and in-house team capabilities to handle unique needs of specific provider types and specialties. Contact us to see how we can help your organization.
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Pricing
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Pricing
- Pricing Options
- ROI Assessment Tools
  
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  ROI Assessment Tools
  Talk To A Solutions Expert
  
  Prior Authorization Calculator
  
  A/R Recovery Calculator
Custom Pricing, Scoped To Your Needs
Annual engagements start at $5,000 per month. Start with discovery, then get a recommended solution mix and pricing approach, plus the inputs needed for a clear quote. Depending on scope, pricing may be structured around volume, dedicated capacity, outcomes, or managed services.
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Patient Access

HIM & Medical Coding

Revenue Integrity

Medical Billing

Revenue Acceleration

Healthcare Contact Center

Full Service RCM Optimization

Healthcare Revenue OS

Revenue Cycle Agent Platform

EMR, EHR, PMS, LIS, RIS Integrations

Payer, Clearinghouse & Benefit Manager Connections

Security & Compliance

Custom Solutions

Document Capture Plus

Patient Access Plus

RCM Plus

Revenue Cycle Agent Platform

Agent Catalogs

Tackling RCM Challenges Unique To Specific Specialties

Ambulatory Surgery Centers (ASC)

Acute Care Hospitals

Rural Hospitals

Physician Groups

LTC Pharmacies

Dental Practices

ROI Assessment Tools

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