Revenue Growth Enablement
Turn your financial data into strategic growth with AltuMED’s enterprise revenue intelligence system. Use our predictive analytics and actionable insights to identify revenue growth opportunities and reduce risk.
Ready to unlock your true financial potential?
Challenges Of Conventional Revenue Cycle Analytics
Siloed Systems
Disconnected EHR, billing, and payer data often cause RCM discrepancies that disrupt cash flow.
Reactive Firefighting
Manual tracking makes it difficult to work on all the denials. This leads to practices reworking a lot of unattended denials, increasing the overhead cost.
Inability to Forecast
With no predictive model on the backend, providers fail to simulate the merger impact or even decipher patterns that lead to denials and audits.
What Is Revenue Growth Enablement?
It is a proactive way of using revenue cycle analytics for financial growth. It effectively addresses the above challenges to keep the revenue on the right course. It is a specialized solution for practices that cannot afford to go slow with legacy data techniques.
Revenue growth enablement works by:
- Predicting financial risks before they affect margins
- Prescribing the most adequate solutions to optimize RCM performance
- Presenting strategic intelligence to leaders to drive growth
In simple words, RGE is not just a way to monitor performance. It is a pathway to engineer your revenue growth.
AltuMED’s Smart RCM Analytics Framework
Predictive Analytics Engine
This feature is a preemptive genius to save you from future trouble. It performs the following functions:
- Denial risk scoring: Assigns scores to claims based on their tendency to get denied.
- Cash flow forecasting: Simulates the impact of mergers and the inclusion of new services.
- Payer contact simulation: Hypothesizes payer dealings and suggests appropriate terms to include in real-life negotiations.
The insights from the Predictive Analytics Engine help ensure 92% billing accuracy. Here is how we train this AI engine:
We have normalized 5M+ de-identified claims from 200+ hospitals across 120+ dimensions, e.g., payer rules, CPT hierarchies, and modifier patterns.
Our transformer neural networks analyze temporal relationships (e.g., the impact of CPT updates on modifier usage).
Our certified coders audit AI predictions every week to create reinforcement learning feedback loops.
Prescriptive Action Hub
This feature suggests the next best actions in the RCM process.
- Root-cause analysis: An AI system that looks into each denial and identifies its root cause. It can even spot modifier misuse, the most nuanced yet significant reason for denials.
- “Next Step” alerts: Specialized billing dashboards to suggest the next best steps to billers and coders.
- Customizable workflow triggers: An automated action center that performs scheduled functions. For instance, the system sends reminders to payers to escalate aging A/Rs.
Financial Growth Dashboards
This is one of the most important features of our smart RCM system. It includes the following functions:
- Service-line profitability dashboards: Track ROI by specialty/physician/location with drill-down capability
- Payer performance benchmarking: Compare reimbursement rates against regional competitors
- Compliance Exposure Heatmaps: Visualize audit risks by department or specialty
- Resource Allocation Simulator: Model staffing impacts on A/R days before making hires
Why Our Revenue Cycle Analytics Stand Apart
We use smart reporting to drive growth and reduce cash disruptions. Here is what we offer:
- Enterprise-scalable AI: Artificial intelligence models trained on billions of claims’ data from large hospitals
- Bidirectional FHIR API Integration: Utilization of HL7® FHIR standards to create real-time, two-way syncing between EHRs, billing systems, and payer networks. It works by:
- Automatically ingesting patient demographics, codes, and charges from scheduling modules
- Pushing denial risk alerts directly into clinician workflows
- Syncing payment postings back to accounting ERPs
- Clinical-financial linkage: A smart system that links documentation and coding with reimbursement rates
- Dedicated team: A highly dedicated and qualified staff consisting of certified coders, data scientists, and revenue leaders
Start your Journey with Us
Ready to engineer margin growth that’s substantial and sustainable?
Choose our RGE framework and see the difference yourself.