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Solutions
Description
Compatibility Level
Clients
Use cases
EHR integrations
Client types
Differentiators
Keywords
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Company details
Jump to:
Categories
Solutions
Description
Compatibility Level
Clients
Use cases
EHR integrations
Client types
Differentiators
Keywords
Media
Company details

Categories

Solutions

Description

Product Description:

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.

About Sift Healthcare:
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.
Product Description:
MedData is more than just a vendor that improves A/R metrics. We are a trusted partner providing end-to-end revenue cycle management solutions for hospitals and physicians across all payer types. Because of our range of capabilities, we are able to handle any account regardless of origin – high/low dollar, re-billing, secondary/coordination of benefits, government payers, out-of-state Medicaid, accident accounts, Workers’ Comp, denials, etc. – and under any circumstances – small balance insurance follow-up, project-specific/work down of aged A/R, legacy receivable conversions, or as an extended business office. We triage accounts to identify problems and then share that knowledge with the hospital, which helps improve internal processes by fixing issues that contribute to avoidable denials. Our trending reports are based on specific KPIs established together with the hospital and delivered at the hospital’s preferred frequency. We track payer, denial type, service, and other trends to help drive improvements in a hospital’s processes that will lead to long-lasting gains in A/R performance. MedData has the capability to send out electronic 270/271 eligibility inquiry and to receive the response. We leverage the 270/271 response feature for many different scenarios such as: • Pure self-pay: to discover another payer source • Resolve issues with payer information that is on record in your system • Verify payer filing order We can process electronic claim submissions performing edits in any system and scrubbing where appropriate as well as working from any claim editing software. Our platform manages all elements of the project, giving the hospital full transparency into account activity and status. And it is administratively simple: We can work directly with any hospital-based billing system (Epic, Cerner, Artiva, Soarian, Meditech, Paragon, Star, Allscripts, and Invision). MedData has been performing revenue cycle management services for 40 years, and 100% of our business is in the healthcare industry. Our experienced and tenured team has been performing A/R recovery services for a variety of client types and sizes for more than 10 years. We have advocates, specialists, and leadership with expert knowledge of denials management, billing, guidelines, procedures, and compliance who are ready to respond to a hospital’s needs and meet its A/R goals.
About MedData:

MedData has been a tenured and trusted healthcare revenue cycle management services provider for more than 40 years, delivering technology-enabled and patient-focused RCM solutions, including Eligibility & Disability, Accounts Receivable Services (ARS), Injury Accounts (Workers’ Comp, Auto, etc.), Veterans Administration, Patient Responsibility/Early Out, COB Denials, and Out-of-State Eligibility. MedData has patient advocates from coast to coast and experience with hospitals and health systems of all types – large to small, rural to urban, nonprofit to for-profit – giving the company a nationwide presence with a local feel that’s scalable to any volume. Click the "Files" tab for downloadable content with more information about our organization.

Compatibility level

Select which hospital or health system you work at and see a personalized compatibility level.

Clients

Select which hospital or health system you work at and see the client list

Use Cases

Description:

Sift’s ML scores efficiently identify opportunities to prioritize staff touches on high-complexity accounts and leverage automation on low-complexity accounts, enabling providers to better facilitate AR management and accelerate cash.

Pediatric use cases:

None provided

Users:

VP of Revenue Cycle, Revenue Cycle Director, Denials Team, Revenue Cycle Teams

Description:

None provided

Pediatric use cases:

None provided

Users:

None provided

EHR Integrations

Integrations:

Acute care EMR, Ambulatory EMR, Access +/or revenue cycle

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

Allscripts, Cerner, CPSI, eClinicalWorks, Epic, Other

Hardware Compatibility:

Desktop, Other

Integrations:

None provided

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

None provided

Hardware Compatibility:

None provided

Client Types

Differentiators

Differentiators vs EHR Functionality:
  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.
Differentiators vs Competitors:

None provided

Differentiators vs EHR Functionality:

None provided

Differentiators vs Competitors:

None provided

Keywords

Images

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Sift Healthcare Fully Leveraging Payments Data To Prevent Denials.png

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Videos

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No videos provided

Downloads

media thumbnail
Sift Denials Solutions.pdf

No content provided

Alternatives

Company Details

Founded in 2017

Founded in 1980

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