Urgent Care Coding & Billing Services
ApexonHealth has 15+ years of experience in serving Urgent Care Organizations. Our solutions and services are built to cater the Urgent Care Centers coding and billing needs.
Newton AI Automation solutions
Our solutions will maximize profitability of your Urgent Care Centers operations. Our Urgent Care Center Operations teams are supported by our AI driven RPA solutions customized to provide you long-term benefits.
Years Supporting UC RCM Organizations
Visits Managed Per Year
UC Bots Deployed
UC Experienced Employees
Urgent care specific AI solutions
ApexonHealth over the last 4 years has been an early pioneer/investor in UC specific AI solutions. These solutions have been implemented for multiple UC Centers. Key benefits include:
- Consistently achieve higher acuity levels (70%+) than national MGMA standards (56%)
- 6%+ higher reimbursement compared to national standards
- OIG Compliant and mathematically proven sampling techniques
We are consistently achieving the above by increasing the performance of experienced UC RCM operations team. Some of the advanced solutions that create sustainable revenue and margins for all stake holders include:
- AI driven assisted coding (customized for each customer)
- Machine learning driven denial prediction models (customized for your operating environment)
- Advance BI reporting including Physician productivity, revenue leakage, CDI, revenue forecasting etc.
- Loss prediction models
- Intelligent workflow (integrating above components)
- Experienced UC RCM operations and audit teams
Error Prediction Tool
Productivity improvement by upto 40%
Denial reduction by 25%
Medical Necessity accuracy at 95%
Physician productivity measured to accurate
CDI issues reduced by 50%
Accurate Bonus calculation
Increase in revenue by 1 to 2%
UC Full Cycle RCM Services
- Eligibility Valdiation
- Expert coding services
- Charge Entry & claim submission
- AR Follow-up
- Payment Posting
Newton AI Solutions
- Eligibility automation
- UC Assisted coding solution
- Charge Entry Automation
- Denial Prediction
- AR Automation
- Payment Posting Automation
- QA Audit solutions
- CDI Solutions
Reporting & Actionable insights
- Provider Productivity Room Reports
- UC Center Operations
- Operational Reports
- Revenue Cycle Financials
- Identification of Anomalous Providers
- Revenue Forecasting
Seamlessly integrate our Newton AI Automation Tools & RPA BOTs to boost your revenue
Newton AI Assisted-Coding tool
Uses our ED/UC AI-assisted coding platform that integrates Machine learning, Natural Language Processing(NLP) and Robotic Process Automation(RPA) to automate medical coding. Our coding solution ingests PDF chart, EMR data and also other formats to extract the necessary data for assisted-coding and error prediction, accounts for ‘Critical to Quality Fields’ and generates the automated results for LOS, CPT, ICD, MIPS and Modifiers along with probable reasons and validates medical necessity. In Real-time audit process the efficiency increases by allowing the team to focus on the most critical charts while drastically reducing your overall coding costs.
Error Prediction tool
This AI-based advanced predictive algorithm touches all charts predicting the erroneously coded chart and generating audit samples; it works equally well on manually or auto coded charts. It validates correctness of coding and utilises RAT stat models for random sampling. Besides following an OIG stipulated methodology, it also gives recommendations for auditors and helps them prioritise the charts based on anitcipated dollar loss.
ED/UC Quality Audit Models(QA)
Our ED/UC QA models primerly follow three stage quality control process where it starts with establishing of current error rates by randomly picking-up sample claims for a statistically significant volume and audit them to establish benchmark accuracy. At second stage Erroneous claims are picked using various techniquies like Best fit classification model, Loss Recovery Model & OIG Compliance Algorithm, etc. Finally through manual audit we establish audit volumes to achive required SLA and manage focused trip audits.
We use Robotic Process Automation to automate billing process such as Eligibility check, Charge Entry, Payment posting & Remit which reduces mannual billing errors and helps improved compliance standards.
AR Bots & Touch Analytics
AR Bots consists of automated modules of Aging(ATB) Analysis, Work Queue Prioritization, Auto Analysis & Claims Status and take actions based on updated status. Our AR bots with predective moduling helps follow-ups on A/R aging and update the status. This deep learning algorthim coupled with ED/UC speciality driven BI tools enables us to provide insights to Claims touch efficiencies, AR allocation avoidance, and outstanding collectibles.
Provides next-generation advanced analytics to deliver actionable intelligence for ER leaders. SensER aggregates data from multiple transaction systems – revenue cycle management, the hospital’s transaction system, physicians calendar and patient data, and other available sources, to derive critical Operational, Financial, Clinical Key Performance Indicators (KPIs) and creates analytical models. Such deep and detailed analysis of the organizational performance helps physicians improve the overall quality and cost of delivering care.
Urgent Care Coding & Billing Services Case Study