Payers constantly change the rules. Sift evens the playing field. Sift equips healthcare organizations to fully leverage their payments data to work smarter, protect their margins and accelerate cash.

Actionable Denials Intelligence, delivering a longitudinal view of clinical, coding, claims and remittance data. Sift establishes a data foundation that gives providers unprecedented access to their payments data and intelligence tools to better manage their denials, identify root causes and prevent future denials. 

• Unified, normalized and organized claims and remittance data.
• Delivering an accessible and complete picture of claim behavior, payer trends and the drivers of denials.
• Curated, consultative analysis pinpointing where your team can take action to prevent denials and optimize workflows.

Denials Prioritization & Intelligent Automation to better manage touches and lower the cost of delivering each dollar of cash.

• Sift’s machine learning optimizes workflows by prioritizing your team’s denial work efforts around ROI and by delivering Smart Claim Edits that improve first-pass yield. 
• Active-Learning Claim Scrubber analyzes daily claims and remittances to curate high-impact claim edit recommendations.
• Machine learning models that score denials at an atomic claim level, using over 500 attributes to determine each denial’s likelihood to overturn.
• ROI-based denials worklists seamlessly integrate into your EMR, prioritizing high-recovery denials in staff workqueues.
• Scoring that enhances existing automation capabilities, enabling the strategic automation of low-yield accounts while avoiding over-automating recoverable accounts.

Denials Prevention. By unifying clinical, coding and payments data, Sift's ML predicts denials before claims are created and provide recommendations for upstream interventions. 

Sift’s ML models predict the likelihood of denial and provide pointers for intervention and prioritized user analysis, working to optimize payment outcomes.

• Machine learning models score encounters around their likelihood of being denied, proactively flagging encounters for intervention before claim submission.
• Denial category prediction and root causes pointers enable routing to the appropriate mid-cycle workflow for mitigation.
• Mid-Cycle Denials Intelligence that ties back-end billing, denial and overturn patterns to upstream workflow data inputs to deliver root cause analysis and prevention recommendations.

Sift Healthcare provides intelligent and accessible solutions for provider systems that need to extract meaning and value from their vast stores of payments data. Sift organizes and normalizes all of your payments data in one location, providing a holistic view of collections. Our denials and patient collection dashboards, payer scorecards, propensity to pay tools, market intelligence reports and enriched patient profiles enable revenue cycle teams to optimize workflows and accelerate cash flow.

In the complex environment of Case Management and Utilization Review, a people-driven process inherently leads to error and lost revenue. To optimize the process to capture appropriate revenue, prevent denials and reduce Length of stay requires people and their ability review a case consistently. The legacy tools accessible today create a process highly dependent on human capital. What humans can’t do, Artificial Intelligence can. XSOLIS uses Artificial Intelligence (AI) to predict appropriate patient status (observation vs. inpatient), build automated defense of patient status, and identify Length of Stay reduction opportunities. Our technology can now interpret a medical record more accurately and more often than a person in many cases, and technology becomes unparalleled when it isolates risk in the complexity of a hospital today so issues can be mitigated in real-time. To assess a case today – the appropriate patient status, denial risk, and when a patient is ready for discharge – involves highly complex processes with thousands of variables and decision trees that are reliant on a manual review process. The XSOLIS Cortex platform transforms the manual review process today and automatically interprets a patient’s medical record in real-time. It automatically suggests appropriate status, brings awareness to revenue sensitive cases, drives intervention to denial mitigation situations (in real-time where it’s most preventable), and identifies Length of Stay opportunities to ensure highly efficient operations. Over 150 hospitals are currently contracted with XSOLIS and have seen significant results in denial prevention, throughput, Length of Stay, appropriate status conversions, and more. Automation has significantly impacted their revenue capture and has also shifted high value resources toward higher value processes – the clinical, not the clerical.

XSOLIS is a healthcare technology firm focused on improving healthcare operations through cognitive computing in Case Management and Utilization Review. By aligning cognitive computing behind clinical expertise, we're creating a new framework for decision-making to prevent denials in real-time and drive automation in status determinations.

1. ML to predict propensity-to-overturn, enabling dynamic denial prioritization -- rather than rules-based systems (i.e. EMR offerings).
2. ML to predict propensity-to-deny, enabling denial prevention before claims are created. 
3. Rev/Track Insights Reports with curated intelligence and action items.
4. Unified and accessible data foundation, including:

• Matched claims and remittance data
• Unified and normalized payments data
• Payments data matched to corresponding CDI and coding data.