Trisus® Claims Informatics
Charge capture analytics that identify risks to revenue and compliance
In today’s evolving healthcare climate, payment models continue to change from the traditional fee-for-service model to more blended payment methods causing risks to revenue and compliance. Regulatory and payment information changes constantly, and if your systems aren’t updated in a timely manner, claims can be filled with coding errors, missed charges, and compliance issues. All of these items can lead to lost revenue for your organization.
Trisus Claims Informatics, a retrospective charge capture analytical tool, identifies high-impact areas of risk for your team to investigate. This solution was created with the user in mind, based on customer feedback and requirements, and combined with analysis of over 200 million billed claims. By importing both claims and remit data sets from your patient accounting system, Trisus Claims Informatics uses prescriptive analytics on your own data resulting in higher accuracy of issues found. You can also see the potential gross impact of an issue, giving you quantitative data on potential revenue loss.
Trisus Claims Informatics helps you identify these risks through:
- Drill-down dashboards to quickly identify high-impact issues
- Root-cause analysis wizard which walks the user through the steps of auditing to correct the issue at the source
- Issue grid that is easily sorted, grouped, and filtered
- Potential gross impact identifying potential revenue loss
- Actual impact to display actual revenue loss after remittance
This robust tool is built on our next-generation cloud-based platform, Trisus, allowing for daily imports of your claim and remit data, as well as frequent updates from Craneware to quickly adapt to industry and regulatory changes. These features, combined with the most accurate and current reference data in the industry, ensure your team’s success with post-bill audits.
During implementation, our consultants, who have a passion for revenue integrity, visit your organization on-site and perform a sample audit to identify your top five high-impact issues. Our consultant works with your team to audit, discuss corrective action plan development, and how to implement the plans. Our methodology includes training, workflow development, customized rules, and report creation, positioning your team for success.