Your revenue cycle should be in your hands.
One of the biggest challenges health plans face while working their submission errors is determining how to prioritize corrections. By working the high risk errors first, plans can recapture the greatest possible revenue in the first or second sweep, allowing them to get paid for these claims earlier than if they were to work through the errors blindly. But how can you determine which errors are the “best” errors to work first?
With Babel’s unique cloud-based R3 Insight© tool, plans have the ability to identify and prioritize claims by risk, reconcile discrepancies and positively impact revenue. They can also forecast payments utilizing the financial overview by sweep reporting capability. Additionally, the submission gap analysis feature allows plans to easily find and reconcile discrepancies between EDPS and RAPS submissions to ensure CMS compliance.
R3 Insight is included at the core of Babel’s EDPS/RAPS submission platform. However, even if your plan doesn’t currently use the Babel platform for submissions, they can still use R3 Insight as a standalone tool for advanced risk, revenue and comparative reconciliation analysis, as well as to evaluate the effectiveness of your current vendor.
With R3 Insight, your health plan can:
- View risk score and payment projections by member or contract ID
- Identify member HCCs in rejected claims
- Rank and prioritize error correction activities by revenue amount of the rejected claim
- Project yearly payments by sweep
- Ensure the highest risk claims are paid sooner rather than later