The Concuity platform is a web-based technology that provides healthcare organizations a means to manage the entire contract lifecycle. It goes beyond calculation engines, giving providers the visibility and control they need to create and negotiate the best contracts, streamline contract interpretation and compliance, and collect what’s rightfully owed.
“We found Concuity’s delivery model to be extremely flexible, allowing us to meet our aggressive revenue objectives without having to increase resources or go through an extensive IT implementation.”
Bill Douglas, Chief Financial Officer, Riverside Medical Center
Features
Reducing Underpayments
Payment Integrity Compass uses an advanced calculation engine to pinpoint all occurrences when you have been paid differently to your contracted rate. Furthermore, easy to use custom rules engines mean that ‘false positives’ are filtered out before wasting collector time and effort.
- Automate identification of all payment variances
- Prioritize by appeal success rate
- Batch appeal for optimal efficiency and recovery
Managing Denials
Payment Integrity Compass enables you to track and resolve denied claims as well as identify the root cause of the denials to prevent them from occurring in the future.
- Streamline denials management using best practice categorization
- Assess trends by contract, service, or collector
- Prioritize appeals for optimal recovery
Improving Payer Relations and Contract Negotiations
Eliminate the data and information gap through Contract Modeling
- Model proposed terms to assess financial impact
- Be confident that actual reimbursement on a contract will match expected reimbursement, ensuring a fair deal for all parties
- Install feedback loop to monitor specific payment outcomes
Increasing Business Office Efficiency
Automate Work Queues and Hardwire Accountability
- Manage and prioritize staff work queues automatically
- Alert supervisor to all unwarranted write-offs
- Monitor staff and payers to ensure contract compliance
Simplifying Financial Reporting and Analysis
Deliver powerful reports using our online, built-in custom report writer
- Create custom management reports using any data point in Concuity
- Create payer performance reports at the touch of a button
- Create staff performance reports to track productivity within the system
- Export all reports to excel or pdf