For healthcare providers, ensuring accurate payments for services is critical. MD Clarity enables the identification of systemic patterns that result in incorrect allowable rates based on your contractual agreements with payers. Given the complexity of today’s payer-provider contract terms and ever-changing payer reimbursement methodologies and policies, the level of sophistication built into MD Clarity’s automated analysis is essential to monitoring the accuracy of payments your healthcare system receives. By using this kind of analysis, your healthcare organization will increase net revenue and more confidently validate future payments as contracts and payer policies change over time.

Insurance Performance Metrics

We offer our customers a range of performance metrics, enabling them to quickly identify issues with contracted payers. These reports let our customers quickly identify not only which payers are not meeting their contractual agreements, but also which contracts have a higher overall yield and how insurance payments stack up against patient responsibility. Additionally, we understand that different healthcare systems seek different analyses, so we pride ourselves in our ability to customize our reports to the needs of our customers.

Reimbursement Analytics

Is your healthcare organization being paid correctly? Between one in five and one in ten claims are reimbursed incorrectly by insurers. Traditionally, claims are spot-checked manually to provide insight on payer performance. MD Clarity automatically audits every claim, identifies trouble spots, and organizes this data into reports, showing precisely where contractual errors are being made. Now your staff can purely focus on true appealable opportunities.

Procedure Category Metrics

This lower-level suite of reports provides more granular detail on how our customers’ payers are performing. These reports enable our customers to pinpoint types of service where an insurer is systematically making a claim adjudication error. Further, we show trends based on time, problems with individual procedure codes, and specific claims from our customers’ billing data where there are inconsistencies.

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Optimize Revenue

Identify, track, and reform trouble areas in revenue flow.

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Quantify the impact of changing pricing models

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