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

Categories

Solutions

Description

Product Description:

There is a different way to work. If you were to reimagine the way you run your business, what would you do differently? What if you could save up to 80% of your operational costs by reimagining the way business outcomes are delivered?

Through the power of automation emerging technologies, we challenge you to think differently about how you work and how you use your people to full effective.

We can help you across the automation journey from thinking through your strategy to implementing and executing robotic process automation, machine learning and other emerging technologies across the enterprise.  

Revenue Cycle Management:

Prior Authorization ​

Insurance Claims - Posting

Patient Payment - Posting

Coordination of Benefits: Primary, Secondary, & Tertiary

Revenue Integrity - Payment Audits (Under & Over)

Provider: Insurance Enrollment

Revenue Integrity - Charge Description Master (CDM) Management

Revenue Integrity - IME or IMR Audits (CMS & Medicare Advantage)

Insurance Claims - Denied & Rejected Follow-Up

About TQA Healthcare - Formerly Element Blue:

TQA Healthcare enables healthcare and life sciences organizations to transform the patient experience and reduce costs through increased personalization, intelligent automation, and AI. 

The practice’s solutions impact patient access, the revenue cycle, order processing, and clinical needs at the most critical stages of the patient journey, resulting in a seamless encounter.

By empowering individuals to actively manage their unique experiences, TQA Healthcare increases the satisfaction of every healthcare consumer: patients, staff, and clinicians.

Houston-based, TQA Healthcare is formerly Element Blue. 

Product Description:

XpertCoding is a revolutionary technology that leverages advanced natural language processing (NLP) and machine learning algorithms to code medical claims within 24 hours automatically. By streamlining the coding process, XpertCoding enables faster claims submissions with unparalleled accuracy, resulting in maximized financial gains for clients. The breakthrough technology behind XpertCoding sets it apart as a game-changing solution for medical coding, providing a more efficient and effective alternative to traditional coding methods.

About XpertDox:

XpertDox is a software company providing a suite of products and services centered around using smart technology for healthcare administration and patient experiences. Its products include XpertCoding, an autonomous coding solution that accelerates the revenue cycle; XpertTrial, a clinical trials database management, search engine, and patient recruitment platform custom-built for each healthcare organization; and XpertScreen, a physician-facing internal platform for automated pre-screening, referral, and recruitment. XpertDox was founded in 2015 and is based in Birmingham, Alabama.

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:
  • Prior Authorization
  • Claims Status
  • Coding
  • Scheduling
  • HIM
  • Remittance Posting
  • Provider Credentialling
  • Accounts Payable
  • Human Resources
  • Clinical Services
  • Patient Access
  • Revenue Cysle Management 
  • Supply Chain
  • Finance
  • HR
  • Referrals
  • Faxes
  • PDFs
  • Emails
  • Scans
  • Invoices
  • Patient Charts
  • Patient Records
  • Lab Orders
  • Mail
  • Paper Documents
  • Resumes
Pediatric use cases:

Same as for any health system, but additional applications related to newborn insurance and patient proxy for infants and children.

Users:

Revenue Cycle Leaders

Finance Leaders

IT Leaders

HR Leaders

HIM Leaders

Operations Leaders

Description:
  1. Hospitals or Practices can use XpertCoding to submit claims faster, more accurately, and save costs.
  2. RCM Companies can use XpertCoding to submit claims faster, more accurately, and save costs for their clients.
Pediatric use cases:

XpertCoding is implemented at multiple pediatric practices where it automates the medical coding process.

Users:
  • Urgent Cares
  • Urology Practices
  • Pediatric Practices
  • Primary Care Practices
  • Hospitals with large urgent care, pediatrics or primary care presence
  • Any medium to large single-specialty practices

EHR Integrations

Integrations:

Acute care EMR, Ambulatory EMR, Ancillary EMR, ERP system, Patient portal, Pop health platform, Home health, Behavioral health, Community based organizations, ADT, Access +/or revenue cycle, Credentialing, Website / public online sources, Other

EMR Integration & Relevant Hardware:

Not applicable

EMRs Supported:

Epic, Cerner, Meditech, Allscripts, NextGen, athena, GE, eClinicalWorks, McKesson, Other, Allscripts/Eclipsys, Athenahealth, Azalea Health/Prognosis, CPSI, Evident, Healthland, MEDHOST, MedWorx, QuadraMed, Self-developed, Would prefer not to disclose, Point Click Care

Hardware Compatibility:

Not applicable

Integrations:

Acute care EMR, Ambulatory EMR, Ancillary EMR

EMR Integration & Relevant Hardware:

Required

EMRs Supported:

Epic, Cerner, Meditech, Allscripts, NextGen, athena, GE, eClinicalWorks, McKesson, Other, Allscripts/Eclipsys, Athenahealth, Azalea Health/Prognosis, CPSI, Evident, Healthland, MEDHOST, MedWorx, QuadraMed, Self-developed, Would prefer not to disclose

Hardware Compatibility:

Not applicable

Client Types

Awards

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Differentiators

Differentiators vs EHR Functionality:

While EHRs offers integration tools, achieving seamless data exchange, particularly with non-EHR systems, can be challenging due to their limited interoperability.

This can create communication hurdles between providers using different EHRs, healthcare facilities not on a particular EHR, and providers who need to integrate with other advanced technology platforms outside of the EHR ecosystem.

Element Blue's solutions can integrate with any platform and are independent of particular products or technologies. This affords our teams unlimited creativity when ideating custom solutions for each healthcare organization.

Differentiators vs Competitors:

Element Blue's practice is dedicated exclusively to healthcare and life sciences. This is unique among our UiPath competitors, who serve multiple industry verticals.

A UiPath Platinum partner, Element Blue is recognized as a leading systems integrator with more than 20 years' experience in working with some of the world's best known providers, payers, diagnostics, and life sciences organizations.

Differentiators vs EHR Functionality:
  1. XpertCoding is a fully autonomous medical coding solution, whereas EHRs only offer computer-assisted coding that requires provider input and a coding team.
  2. XpertCoding provides a Dashboard to monitor claims and perform advanced analytics across all their location, whereas EHRs do not offer a coding-focused Dashboard.
  3. XpertDox offers a Clinical Documentation Improvement module not offered by EHRs.

Differentiators vs Competitors:
  1. XpertCoding can autonomously code >90% of the claims, whereas competitors may only code 60 to 80%.
  2. XpertCoding offers a free pilot program, whereas most competitors don't.
  3. The training period for XpertCoding is less than four weeks, compared with many months and even a year with some competitors.
  4. XpertCoding offers a comprehensive Dashboard for monitoring, data analytics, CDI, and audit trail. The competitor's Dashboard may or may not be as robust.
  5. XpertCoding does not require any IT support from clients, whereas many competitors require some help from the IT team.
  6. XpertCoding is HIPAA, ISO27001, and SOC2 Type 2 certified from a security perspective, whereas some competitors do not carry such certifications.
  7. XpertDox is ISO22301 certified for business continuity, whereas some competitors may not have the certification.

Keywords

Images

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Videos

1 of 3

Epic Claim Denial Resubmission with BCBS.mp4

No videos provided

Downloads

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66329_EB RPA Case Study REVISED.pdf
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XpertCoding Flyer.pdf

Alternatives

Company Details

Founded in 2015

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