Business Intelligence and Analytics
Business Intelligence and Analytics
Healthcare organizations today face mounting pressure to deliver exceptional quality care while managing costs in an ever-evolving landscape. More and more executives are recognizing the value of analytics in driving cost control, enhancing clinical outcomes, and improving patient satisfaction. At Vertex Medical Billing, our healthcare business intelligence and analytics solutions empower providers to deliver high-quality care while keeping patient costs in check. Our comprehensive analytics services offer the tools, expertise, and project management support needed to unlock actionable insights and optimize healthcare delivery.
In a data-centric industry, the opportunity to leverage data for value creation has increased exponentially. Clinicians and healthcare payers are relying on data analytics to gain insights into patient behaviors and meet organizational objectives.
Outcome-Driven Approach:
Our analytics solutions identify the foundational objectives important to your organization, then deliver business and clinical value by providing actionable insights from your data that lead to intelligent and knowledge-based decisions.
Descriptive: (What Happened?)
- Operational: Workforce and supply chain
- Revenue cycle: Net revenue denied, under-paid, and uncollected self-pay
- Clinical analytics: Pay-for-performance reporting and compliance
Prescriptive: (What Should Happen?)
- Operational: Remove redundant workforce to save costs
- Revenue cycle: Prescribe the operational change needed to reduce denial rates
- Clinical: Personalized wellness program to reduce anticipated illness
Predictive: (What Will Happen?)
- Operational: Predict patient in-flow/admission for specific diseases
- Revenue cycle: Revenue at risk – Potential lost revenue and/or opportunity
- Clinical: Avoidable ED visits and hospital re-admission
Clinical Analytics
At Vertex Medical Billing, our clinical analytics solutions are designed to deliver actionable insights into clinical operations. We help proactively predict adverse health events, identify chronic conditions, reduce ER visits, pinpoint high-risk patients, prevent hospital readmissions, and enhance care coordination for improved patient outcomes. We specialize in identifying and ranking high-risk chronic patients to help healthcare organizations prioritize their care coordination efforts effectively. Utilizing probability modeling, we predict future health events and outcomes, allowing for proactive intervention. Our services include tracking the utilization costs associated with managing both high-risk patients and the broader patient population, providing valuable insights into overall healthcare spending. We also monitor the quality of care at both the facility and provider levels to ensure optimal patient outcomes. Additionally, we create a virtual environment to stratify and assess the impact of guideline or regulatory changes, enabling healthcare providers to adapt strategies and improve care delivery efficiently.
Revenue Cycle Analytics
Vertex Medical Billing’s revenue cycle analytics are designed to optimize and streamline revenue cycle processes, ensuring maximum revenue capture while maintaining optimal cost efficiency. We offer comprehensive denial analytics to identify patterns and root causes of claim denials, helping healthcare organizations improve their revenue cycle processes. Our services include in-depth analysis of payer behavior and underpayment and zero payment trends, providing valuable insights to optimize collections and minimize revenue loss. We implement automated RCM performance metrics to track key indicators in real-time, supported by detailed analysis of write-offs and appeals data to identify opportunities for recovery. Our solutions ensure seamless data integration across systems, culminating in detailed and insightful dashboard visualizations that present actionable information for informed decision-making and enhanced financial performance.
Business Office Analytics
At Vertex Medical Billing, our operational analytics are aimed at empowering administrative and operational decision-making across key areas such as customer acquisition, workflow optimization, and market intelligence.