Provider Solutions

Powered by Newton AI

Impacting the bottom line
by providing unsurpassed value, quality and business insights

Revenue Cycle Management

Our team of highly-skilled professionals work towards helping your organization’s progress by reducing the cost-to-collect, improving net collections, and and using automated technology to derive better process performance, quality, and turnaround time.

Our proprietary Newton AI platform automates and provides greater insight for physicians, HIM, account receivables, and billing professionals.

Features

R

Full Service RCM

Eligibility validation, demo/charge entry, A/R follow up and payment posting

Automation

Medical records extraction and coding automation

Insights

Insights in missing procedure and diagnosis codes

Benefits

Financial

Significant productivity gains with reduction in turn-around time by more than 60%

Efficient

Expertise in multiple practice management systems, specialties, and EMR(s)

Quality

Highly trained resources average 4+ years of healthcare experience

Coding /  HIM Services

ApexonHealth offers comprehensive coding services as part of our full revenue cycle management and medical billing services, or as a standalone serivce for organizations doing thier own billing.

Our solutions are highly flexible and use innovative technology platforms and automated workflow solutions. We deliver a variety of reports to track quality and key metrics with value-added services including DNFB reconciliation, compliance reporting, provider deficiency reporting and more.

Features

Documentation

Clinical documentation improvement

Predictive

Predictive CPT, HCPS, diagnosis, HCC, and RAF scores

l

Coding

Code audit services

Benefits

Financial

Reduced revenue leakage

Efficient

Customized process flows including predictive analytics to improve coding quality and reduced CDI deficiencies

Quality

Improved patient risk profile

A/R and Denial Management

Our team handles all critical functions involved in A/R management, including filing of appeals, assessing insurance low pays, updating insurance contracts, managing unapplied balances, managing refunds, and processing patient statements and deliquency letters. 

We use cutting-edge technology by combining business intelligence, actionable intelligence and advanced analytics to manage and analyze data, then create information to support business decisions and solve business problems. Our efficient, automated workflow tools provide our clients with extremely detailed and thorough reporting on every claim worked on.

A/R Management Features

Follow Ups

Insurance and patient follow up

Clean Ups

Old A/R clean ups and resolutions

Balance

Credit balance and appeals

Denial Management Features

Predictive

Predictive denial scoring engine

Analysis

Root cause analysis AR follow-up

i

Reporting

Actionable reporting

Benefits

Financial

Follow ups of predictive claims and uncovering root cause of denials

Efficient

Make claim edits or scrubber more efficient

Quality

Reduction in A/R days, Increase in Collections, Reduction of 90+ A/R

Executive Dashboards

ApexonHealth provides analytical toolkits, data warehouse solutions, and actionable intelligence using visualization software to help providers deliver high quality care and attain their financial and compliance goals

Features

Physician Tools

Physician productivity, anomaly and benchmarking

 

Collection Tools

Collection insight and forecasting

 

Optimization

Hospital resource optimization

Benefits

Financial

Significantly improves financial performance

Efficient

Customized process flows including predictive analytics to improve coding quality and reduced CDI deficiences

Quality

Improved patient risk profile

Revenue Integrity

ApexonHealth helps the HIM/Revenue team using Newton AI solutions to capture and bill all charges. We have a deep understanding of Provider billing and typical causes for revenue leakage. Our approach is to combine our strong domain knowledge with industry leading technology to deliver business results that exceed our client’s expectations.

Features

Tools

Code audit, denial management, and AR management tools

c

Optimization

Code adequacy analyzer and collection optimizer

Coding and Scoring

HCC code and RAF scoring engine

Benefits

Financial

Forecasts cash collection

Efficient

100% of code audit review using  machine learning

Quality

Accurate prediction of encounter level denials

Learn About Our Risk Free Proof of Concept

Learn about Our Risk Free Proof of Concept