HPAC Denial Analytics

HPAC Denial Analytics is the newest addition to the Orbograph Healthcare Payments Automation Center (HPAC) solution – the industry’s leading platform for automating healthcare payments and remittances while providing a variety of healthcare analytics.

 

Healthcare Providers populate the HPAC solution with a robust set of healthcare claim, remittance and payment information including EDI 837, EDI 835, EOBs, ACH, and checks. This revenue cycle data includes notification of denied claims. Transaction data is viewable via the HPAC Portal, and feeds the business intelligence infrastructure.

HPAC Denial Analytics provides organizations with detailed reporting and insightful metrics on the performance and trends of denials identified either via ERAs or EOBs. The result is to maximize the recovery of revenue on denied claims, reduce leakage, and shorten accounts receivables.

The system offers a highly intuitive user experience which facilitates use by C-level and revenue cycle management, directors or managers of denials groups, as well as billing specialists. HPAC Denial Analytics allows users to either view high level denial totals/dollars or filter and analyze a myriad of levels and categories including:

  • Claim Adjustment Reason Code (CARC)
  • Remittance Advice Reason Code (RARC)
  • Claim Status
  • Payers
  • Providers (Rendering Physicians)
  • HCPCS
  • Diagnosis

Using a well-defined methodology to identify the most denial-prone entities within each category will enable the user to create a more efficient recovery process as well as a proactive program for denial prevention.

 

Testimonial

“HPAC Denial Analytics enables a “Denials Prevention” environment based on best-of-breed analytics and business intelligence capabilities targeted dramatic reductions in denied claims.”

- Phil Hetrick
Healthcare Payments/Revenue Cycle Sales Product Specialist

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