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Claims Data Analytics

Get actionable intelligence into revenue cycle
performance with our advanced predictive analytics
platform, Revenue Insights (IRIS).

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Data Designed To Optimize RCM

With the rise in A/R and denials data combined with the constantly changing payer reimbursement requirements, it can be nearly impossible for healthcare finance executives to forecast reimbursements and champion an action plan for revenue cycle workflow improvements at their organization.

Advanced analytics are becoming increasingly critical for data-driven decisions and proactive planning in the revenue cycle management (RCM) space. Common analytic modules provide RCM insights through standard reports and pre-defined static dashboards resulting in a underwhelming experience for finance leaders as there are no insights as to what will likely happen to their A/R and what actions or process improvements should take place to collect outstanding reimbursements, regardless of aging.

Meet IRIS, AI-Powered Revenue Insights

With our cloud-based, AI-powered RCM analytics product, Revenue Insights (IRIS), healthcare finance leaders are now equipped with EMR charge and remit data that is transformed into predictive analytics and actionable intelligence that enables them to quickly digest key revenue cycle metrics to proactively take steps to reduce denials, decrease write-offs and achieve maximum A/R recovery.

A/R & DENIALS INTELLIGENCE

Plan Work For Maximum Recovery

Standard business intelligence models and static dashboards do not capture the significance of factors driving revenue cycle KPIs.

IRIS automatically pulls claims and remit data from your EMR and performs proprietary, multi-modal examination of this data based on billions of data points from our extensive patient access and RCM database and domain expertise.

The results in our interactive dashboards assist revenue cycle teams determine which claims or denials to work on first by providing helpful insights like:

  • Payer balance vs. patient balance
  • How much of payer A/R was denied
  • Aging bucket segmentation with industry benchmarks 
  • Segmentation by payers, denials, denial codes and procedures 
  • Remittance denial rates 
  • Denials by date further segmented by adjustment reason denial code, procedures, facilities and insurance carriers 

Armed with this intelligence, revenue cycle teams can prioritize and route claims to appropriate team members with the right expertise to work the claim or denial.

PAYMENTS TRANSPARENCY

Transform Data To Reimbursements

Get visibility into payer collections and take advantage of how IRIS transforms data to address payment shortfalls, prevent revenue leakage and locate new revenue opportunities. IRIS interactive dashboards display key collection data like like:

  • Collected amounts vs. contractual amounts by CPT/procedures
  • Collection performance by payer
  • Collection performance by facility

Revenue cycle managers can now implement quality and operational improvements to coding and billing workflows to increase reimbursements and prevent write-offs.

BILLING PLATFORM AGNOSTIC

Quick Onboarding = Quick Impact

IRIS is platform agnostic, meaning it can pull from any billing system/EHR/EMR without complicated integrations. As a cloud-based solution with a monthly subscription, revenue cycle teams can quickly bring this tool into their reporting workflow.

Our team of specialists who have been helping clients with patient access and RCM activities for years are available to work alongside you to get the data you need to achieve the results you are looking for.

INSTANT REVENUE CYCLE KPIs

Easy-To-Create Reports For C-Suite

Most senior executives rely on spreadsheets, legacy data management tools, out-of-the-box BI tools and basic template reports to report on past revenue cycle performance for their monthly presentations.

They hit obstacles when trying to present a true picture of the clinical and financial data to report on the organization’s health, discover reimbursement trends and uncover operational insights to improve revenue cycle performance.

Let IRIS prepare detailed financial packages that report retroactive performance with revenue cycle KPIs as compared to HFMA industry benchmarks, and a proactive strategic RCM optimization plan to make an impact for your next stakeholders meeting.

Our clients tell us these packages take days to build and IRIS reports bring immediate value. They now have time to focus on what they were brought on to do.

Client Results

60% reduction of >120 days aged AR in 6 month

14% increase in net collection ratio

60% reduction in cost to collect

40% reduction in denial rates

64% decrease in denial and aging AR write-offs

Client’s Improved RCM Performance

“With IRIS, I feel right in the cockpit of my revenue cycle operations. I now have the all dials and levers I need to monitor and course-correct my RCM operations to improve reimbursements. I am not lost anymore on where to invest efforts, we have become highly efficient and our reaction time to identifying and actioning on opportunities have improved multi-fold.”

Senior Vice President
National Imaging Center Group

“The canned reports from our practice management software barely provides any analytics and insights on our operations. IRIS exceeded our expectations in being able to combine both claims and financial data to provide a single comprehensive overview of our revenue cycle performance across payers, procedures, providers and more. The interface is highly addictive and my team uses it every day to find new opportunities to collect more and efficiently. The reimbursement uplift post using IRIS speaks for itself.”

Chief Operating Officer
Cardiovascular Medical Group, Southwest U.S.

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Uncover Insights & Increase Reimbursements

Learn more about how IRIS, our AI-powered RCM analytics product, can empower your finance and revenue cycle teams to recover more revenue for your organization.