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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’s Denials Management Outsourcing Services improves your business office’s effectiveness by allowing it to concentrate on areas of the revenue-generating process that have a higher yield and do not distract hospital account representatives from their primary duties. We have dedicated specialists who focus on denials management nationwide with extensive experience working with ALL payer types, scenarios and denial reasons. MedData provides invaluable feedback to help the hospital improve its approach to the denial management process. We provide reports on a monthly basis (or as needed) that track payer, denial type, service, and physician’s issues. This helps our clients improve their internal processes that in turn will lead to long-lasting gains in Accounts Receivable performance. MedData works all denial types including: • Lack of Authorization • Insufficient Authorization • Medical Necessity • Unresponsive Recoupments • Coverage Exclusions • Pre-existing Condition • Coordination of Benefits • Timely Filing • Subrogation\Accident Details • All Denial types (administrative/clinical) MedData also has a dedicated focus on unresponsive patient denials (UPDs), which consist of any denial type where the patient’s and/or subscriber’s involvement is required in order to secure resolution on the claim. Our service helps prevent these denials from getting lost in self-pay and ending up in bad debt. UPDs include, but are not limited to: • Coordination of Benefits (COB) • Pre-existing questionnaires • Incident letters • Accident letters • Adding newborns to policies • Subrogation forms • Authorizations • Any other time a patient’s involvement is required by the insurer The benefits of utilizing MedData to perform your denials management is that we have the following performance drivers: • Dedicated RNs on staff for medical necessity reviews, peer to peer coordination, etc. • Primary focus on Commercial and Medicare/Medicaid claims • Strategic focus and prioritization based on dollar balance and/or potential reimbursement, age, and timely filing requirements • OCR capabilities for digitalization of hard copy remits/EOBs • Dedicated compliance team and internal legal resource with nationwide legal partnerships • We aggressively work the account until it is 100% resolved • Complete “feedback loop” to prevent future denials through a rigorous root cause analysis process • Close coordination with contracting department to ensure compliance and provide insight for future contracting • Overturn denials through the appeal processes when necessary • Incoming and outgoing call campaign with the patient • Patient texting capability • Streamlined patient letter series • Skip trace with three levels of escalation
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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Videos

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Downloads

No content provided

Alternatives

Company Details

Founded in 2017

Founded in 1980

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