Helping the Healthcare Industry Managing Risk and Protect Revenue
Over the past decade, the healthcare industry has experienced extraordinary changes, with more on the horizon. Healthcare organizations are under pressure to avoid undue risk exposure and to meet regulatory requirements, including anticipated changes to the Affordable Care Act.
The advent of electronic medical records presents an opportunity to use data analytics software to conduct comprehensive risk assessments and analyze 100 percent of patient data and transactions to identify potential issues or fraud before they negatively impact revenue. CaseWare IDEA® can help you transform large amounts of data in various file types and formats to gain meaningful insights and make more informed decisions.
Gather raw data from disparate systems and source types, clean it to ensure accuracy, and import it into a single platform, while protecting sensitive data and maintaining IT systems and control security
Test systems and processes to ensure accurate regulatory and grant compliance
Organize and analyze financial records, statements, transactions and expenditures, operations information and internal controls
Manage receivables and revenue, preventing unauthorized, duplicate, erroneous or over-payments from being processed
Apply analytic techniques to predict and identify fraud, waste and abuse within the benefits and contributions systems
Search alpha and numeric data to analyze benefit information, medical records, contracts, etc.
Use data visualization to depict important information about key findings
Automate repeatable processes to save hours of effort and reduce manual work
Case Study Headline.
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Healthcare providers, such as hospitals and physician groups, are under pressure to effectively manage a broad network of direct and indirect contractual agreements. If performed manually, analysis of insurance payments in accordance with hospital contracts can be both tedious and time consuming.