Claims Assistant performs a gap analysis on claims files to suggest HCC codes which may have been billed by other providers or by the patient’s primary care provider in the previous calendar year. These codes are suggested to providers in their workflow. Submission of all appropriate codes gives the plans and Medicare a more accurate view of the patient’s condition and anticipated healthcare expenditures.
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For solo practitioners on up to MSOs and ACOs, claims data from payors provides a complete picture of the patient’s interactions with the health care system. Analysis of claims data with Inferscience’s HCC coding app, Claims Assistant, can therefore provide rich insights into those interactions leading to improved reimbursement and reduced costs of care
Claims files are uploaded into Claims Assistant via a web interface, after which the data is mapped by our team in a one-time process. With a few clicks, claims are extracted and intelligent rules are applied to the data. Within seconds the output is displayed in an easy to read format. Output can be filtered in multiple ways and maybe be printed or exported to a spreadsheet.
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In the EHR integrated version, claims analysis insights can be shown to the provider in their workflow in the EHR, thereby maximizing the possibility that action can be taken by the provider based on those insights
Organizations small and large can go live and start taking advantage of the application within days of signing an agreement.
