Software

Revenue Performance Advisor

Revenue Performance Advisor helps providers simplify complex tasks across the revenue cycle, using powerful healthcare technology to drive efficiency.

Seamlessly manages each patient and payer financial interaction through a single, integrated tool that supports the entire revenue cycle, from confirming eligibility to accepting payments.

Packages starting as low as

 

 

An end-to-end solution that helps providers simplify their workflows

Supports over 2,200 payer connections for faster provider payments

Intelligent denial prevention using AI, plus powerful benchmark analytics

Short implementation path gets you up and running quickly

Included modules

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    Eligibility

    This solution helps reduce eligibility-based denials and the subsequent costs incurred by reworking them. It also helps reduce bad-debt write-offs from bills for uncovered services that go unpaid. You can create batch requests or real-time requests to over 2,200 payer connections at the point of service or use the easy-to-code API that integrates with your EHR. The API can be automated to deliver a continuous stream of near real-time responses and update the practice’s patient files in bulk. Responses are also stored for additional workflow tasking or reporting.

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    Claims and ERA

    Claims that are validated and scrubbed before submission typically get paid faster. We provide an easy-to-use claims management solution that includes Medical Necessity and Correct Coding Initiative edits. This helps you submit more complete, accurate claims on first pass to avoid timely and costly resubmissions. You’ll have increased visibility into the entire process, making it easier and faster to get the job done.

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    Patient statements

    Patient statements are designed to help you collect the patient’s responsibility and improve revenue performance. Easy-to-read statements that educate patients on their financial responsibility increase the chances of higher payment and fewer customer service calls.

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    Advanced denials management

    The rejections and denials solution is designed to improve performance by automating your rejected and denied claims process and support increase staff efficiency and accuracy. Your staff can work by exception, so they can quickly spot any rejections and validate and resubmit within minutes. Our in-depth drilling/exporting functionality allow for critical analysis of denials.

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    Paper claims

    Get more complete, accurate claims on first pass to avoid timely and costly resubmissions. You’ll have increased visibility into the entire process, making it easier and faster to get the job done. Paper claim fees are based on usage.

     

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    Attachments

    Attach documents within the solution, including Workers’ Compensation and medical claims, to streamline staff workflows. Users select the document, associate it with the correct claim, and send it to the payer electronically. We will fax or mail the document for participating payers who don’t accept digital attachments.

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    Denial prevention

    Our solution uses AI and machine learning to analyze a provider’s historical remittance data to predict which claims are likely to be denied before they are submitted to the payer. Once identified, those claims are flagged for reviewing staff and added to the claim history, along with any associated rejections. This helps reduce denials and optimize claims submissions. It also provides actionable insights to help you better identify and mitigate potential denials before they happen.

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    Benchmark analytics

    Receive near-real-time, end-to-end visibility into processes and trends that impact your provider performance. This greater level of insight helps optimize productivity, billing, patients’ experiences and your bottom line. Benchmark Analytics features more than 40 reports that track dozens of KPIs. Each report links to claim-level data to easily identify root causes or to fine-tune front- and back-office processes. Benchmark Analytics measures performance throughout the revenue cycle, including clearinghouses, payers, peers, reimbursements, patient payments and your practice. 

Our outcomes
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Brochure

Support your revenue by reducing denials

Download the brochure to learn how Revenue Performance Advisor can help lead to faster reimbursements, improved cash flow and reduced errors in patient billing.

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Brochure

Optimize your revenue cycle

Learn how automating the revenue cycle helps you gain control of the financial aspects of your practice.

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Brochure

Simplify claims submission and tracking

Our brochure details how Revenue Performance Advisor Claims Management can help you get claims right on first pass.

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Frequently Asked Questions

Q: How can you support an organization with multiple tax IDs or NPIs?

A: Revenue Performance Advisor can support organizations with complex billing structures and can set up hierarchies for parent-child accounts.

Q: Do I need to change my merchant processor?

A: No, Revenue Performance Advisor can work with your current merchant processor.

Q: I submit claims directly to payers. Why should I pay for something that is free?

A: Sending claims electronically can improve your clean claim rate, claim re-work efforts and payment adjudication time. Having a single workflow where all your claims are managed in one place allows for in-depth reporting.