The platform utilizes machine-learning capabilities to audit accounts placed with revenue cycle vendors each week, according to Healthfuse. The technology looks at adherence to contractual service-level agreements, best practices and state and federal regulations. If accounts are not worked as anticipated, they are red-flagged and audited to understand the root cause. Healthfuse then works with the vendor to resolve the identified process gap.
“RCM outsourcing is a $30 billion industry. As outsourcing continues to grow, and reimbursement continues to decline, it is increasingly important for hospitals to proactively manage their revenue cycle partners,” Healthfuse President and CEO Nick Fricano said in a news release. “With machine-learning, we are able to spend time closing process gaps, rather than searching to find them.”
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