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

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Categories

Solutions

Description

Product Description:

Janus Health Enriched Claim Status is a game-changer, automating claim status checks and sending rich, line-level claim status data back to your EHR. Save time, accelerate cash flow, and reduce manual claim follow-ups, freeing up your staff for higher-value work. The solution seamlessly integrates with your existing EHR, facilitating easy data exchange and keeping staff in their preferred workflows. 

For even greater AR efficiency, pair Enriched Claim Status with Teleport for Claims. Teleport enables one-click payer portal and account access from within the EHR, saving 60–90 seconds per claim worked.

About Janus Health:

Janus Health is fundamentally transforming the future of revenue cycle work with our groundbreaking end-to-end artificial intelligence platform. Our rich history in healthcare and technology allows us to instinctively understand what it is about revenue cycle management that creates significant challenges for healthcare organizations. We’ve developed Operational Intelligence and Intelligent Automation solutions to aid revenue cycle teams in optimizing their workflows, so they can do more with less and ultimately collect more cash.

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.

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:

Enriched Claim Status automatically checks claim status regularly and sends resolution back to the EHR, removing the need for a user to check payer portals or pick up the phone to check a claim's status.

Pediatric use cases:

None provided

Users:

Hospital billing / AR specialist

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

EHR Integrations

Integrations:

Acute care EMR

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

Epic

Hardware Compatibility:

None provided

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

Client Types

Differentiators

Differentiators vs EHR Functionality:

Enriched Claim Status automates the claim status process.

Differentiators vs Competitors:
  • Exceptionally rich status details returned to the EMR
  • More frequent statusing at a flat rate
  • Impressive automation success rates and minimal down time
  • Connectivity to >80% of payer mix
  • Teleport expedites working appeals
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

Keywords

Images

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Sift Healthcare Fully Leveraging Payments Data To Prevent Denials.png

Videos

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Downloads

No content provided

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Sift Denials Solutions.pdf

Alternatives

Company Details

Founded in 2017

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