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

Categories

Solutions

Description

Product Description:

The Anomaly Smart Response engine leverages the power of artificial intelligence to reverse engineer payer-specific payment logic. Smart Response applies learnings from your own claims history, as well as from all Anomaly live customer and model training data, so our customers benefit from the "network effect" of this shared learning. SmartResponse powers three distinct applications: 

  1. Predict: predicts line-level denials before a claim goes out the door. All predictions are payer-specific and include a predicted denial reason code, and in many cases, we go even further to recommend the next best action for securing payment. This check can be performed pre-billing, or farther ahead in the clinical workflow. Our response time is <10 milliseconds and is available for integration into the workflow via API. 
  2. Detect: provides real-time monitoring and alerting of new denial trends and policy changes. These changes could reflect new payer level health policies, new secondary edits from payment integrity vendors, newly enforced payment rules, subjective interpretations of payment rules and errors on the payer side. Detect is delivered via on-demand reporting through our secure customer portal.  
  3. Recover: generates immediate ROI by identifying and prioritizing unresolved denials with high likelihood of payment. Recover indicates target claims for resubmission or appeal with specific recommended actions for overturn and recovery. Recover is delivered in real-time via API integration, or can be provided via dashboard based on customer preference and workflow.  

Seamlessly embedded into managed care and revenue cycle workflows, Smart Response provides real-time insights to optimize payments. It pinpoints payer behavior changes that impact revenue, strengthens contract negotiations, and enables proactive claims correction—so providers can fix issues before they lead to costly denials.

With Anomaly, healthcare payments become smarter, faster, and more transparent—ensuring providers get paid what they’ve earned.

About Anomaly:

Anomaly is the Intelligent Automation Platform for Health Payment, delivering machine-scale solutions for healthcare’s most complicated problem. We bring health payment certainty by exposing payer behavior from live claims data, at scale. By combining deep industry expertise with advanced AI, we uncover hidden barriers to healthcare payment and deliver automated intelligence to resolve issues at the source. As payer logic evolves, our AI adapts—helping providers stay ahead and maximize revenue.

At the heart of our platform is Smart Response, the AI engine reverse-engineering payer logic in real time. By analyzing payment patterns across hundreds of millions of healthcare encounters, Smart Response detects shifts in payer behavior, predicts denials, and identifies opportunity to recover lost revenue—empowering providers to hold payers accountable.

Seamlessly embedded into existing revenue cycle workflows, Smart Response provides real-time insights to optimize payments. It pinpoints payer behavior changes that impact revenue, strengthens contract negotiations, and enables proactive claims correction—so providers can fix issues before they lead to costly denials.

With Anomaly, healthcare payments become smarter, faster, and more transparent—ensuring providers get paid what they’ve earned.

Product Description:

Our single platform approach provides immediate visibility into revenue cycle opportunities, tackling some of today's biggest challenges with the following Productized Analytics Suite Modules:

  • Workforce Quality Insights (WQI) – Links front-office actions to financial KPIs
  • Patient Access Insights (PAI) – Enhances financial experience pre-service
  • Revenue Integrity Suite (RI) – Reduces denials and compliance risks
  • Productivity Analytics (PA) – Improves staff productivity in real-time
  • Cost Insights (CI) – Targets controllable costs
  • Business Office Suite (BOS) – Unifies patient accounting data
About MedeAnalytics:

Founded in 1993, MedeAnalytics is an innovation-focused company. Over the past three decades, we have worked tirelessly to reimagine healthcare through the power of data—and helped thousands of organizations achieve their potential along the way.

Leveraging state-of-the-art analytics and data activation, MedeAnalytics delivers actionable insights that support payers, providers, employers, and public entities as they navigate the complex healthcare landscape.

Using artificial intelligence and machine learning alongside the most advanced data orchestration in the industry, we empower organizations to optimize their resource allocation, experience superior patient outcomes, and achieve population health management goals.

Compatibility level

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Clients

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Product Capabilities

The Smart Response engine powers three critical AI-driven applications: > Predict: Gain real-time visibility into at-risk payments and take proactive steps to ensure claims are paid accurately the first time. > Detect: Continuously surface new denial patterns and take action before they lead to costly denials and payment delays. > Recover: Identify hidden revenue opportunities by prioritizing unresolved denials, streamlining claims correction, and eliminating unnecessary write-offs.

360° View of Enterprise: Integrates clinical, financial, operational and claims data for a longitudinal view across disparate data sources, encompassing front, middle and back-office functions.

Medeanalytics' Data Science Factory is always generating new components and services to help you automate workflows, detect anomalies, assess risk, anticipate trends, and close care gaps.

MedeAnalytics helps users identify key outliers in their data and distribute the right actionable information to the right people – at the right level – throughout the enterprise. Users easily navigate through scorecards, dashboards, key performance indicators, critical success factors, and other key reporting features. In seconds, they can zoom from high-level KPI’s down to fine-grain transaction detail; from the Executive perspective to the view from any cubicle.

HITRUST Certified, NCQA Certified, AICPA SOC, TRUSTe Certified Privacy Patent-pending technology and industry critical certifications (HEDIS® certified, Data Aggregator Validator (DAV) designation pending)

MedeAnalytics' API ecosystem seamlessly integrates into multiple clearinghouses, payment processors and other third-party tools to bring all applicable registration tools into one platform, resulting in improved operational and financial efficiencies.

MedeAnalytics Innovative solutions help RCM leaders like you predict the denial, the fix, the dollars, and the deposit date – all before the 835 ever arrives. Here’s how we’re driving measurable impact: Accelerated Cash Flow • Predict denials before submission • Reduce Days in A/R • Accelerate cash flow by up to 30 days Increased Recovery Rate • Address issues proactively, not reactively • Fewer write-offs, reduced denials • Improve recovery rate by 20% Reduced Administrative Costs • Focus staff on high-priority denials • Lower labor costs • Save 20 minutes per denial on research & resubmission Revenue Optimization • Prioritize high-dollar claims based on predicted payment likelihood

MedeAnalytics performance analytics consists of real-time insight into quality, how to capture workflow issues at the registrar level to prevent downstream denials, organizing patient data longitudinally.

Patient Access Intelligence is a flexible workflow platform incorporating all aspects of the financial clearance process into a simple task-based work list to support centralized, distributed and hybrid revenue cycle models. With a robust API ecosystem, we seamlessly integrate multiple clearinghouses, payment processors and patient engagement tools to fortify your revenue cycle against data compromises and outages.

Use Cases

Description:

None provided

Pediatric use cases:

None provided

Users:

None provided

Description:

None provided

Pediatric use cases:

None provided

Users:

None provided

EHR Integrations

Integrations:

None provided

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

Epic, Cerner, Allscripts, athena, GE, eClinicalWorks, McKesson, Allscripts/Eclipsys, Athenahealth

Hardware Compatibility:

None provided

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:

Recommended, but not 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, Point Click Care

Hardware Compatibility:

None provided

Client Types

Differentiators

Differentiators vs EHR Functionality:

None provided

Differentiators vs Competitors:

None provided

Differentiators vs EHR Functionality:
  • Detailed and summary level reporting for different views to serve multiple purposes; 
  • Standard and ad-hoc reporting allowing clients flexibility to slice/dice based on unique corporate needs;
  • Incorporation of MedeAchieve across entire RCM portfolio to incorporate metric tracking into key enterprise initiative tracking;
  • Worklisting available throughout the RCM workflow;
  • Vendor flexibility – Plug & play any vendor into existing Mede workflows;
  • Robust rules engine to drive efficiencies and streamline workflows;
  • Integration of AI Agents to streamline and reduce manual entry;
  • Predictive analytics using AI intelligence;
  • Focus on productivity analytics to highlight and stratify registrar performance;
  • Integrated Financial Clearance Workflows to maximize revenue generation

Differentiators vs Competitors:

Enterprise Analytics - MedeAnalytics helps users identify key outliers in their data and distribute the right actionable information to the right people – at the right level – throughout the enterprise. 

MedeAnalytics can measure revenue and practice performance across the entire system. Our approach to organizing data into a patient longitudinal record has led to improved financial, operational, and even clinical performance.

Our Integrated MedeAchieve solution improves strategy execution with action plans that define your objectives, align staff around shared goals, and track progress in a closed­ loop system.

Keywords

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Company Details

Founded in 1993

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