Rapid Validation and 100% Audit of Payments to Tackle Mis-Pays and Denials, and as well, Effective Collection upon Zero-Balance Accounts
Imagine if your old data, the data we will be hyper-ingesting™, hyper-digesting™, and actively using for analytics, contained millions of dollars in recoverable assets from claims and accounts you may have zeroed out or claimed as “bad debt”.
In our pre-launch “Sea Trial” we demonstrated the ability to find an incremental 1.3% of in-date portfolio provided by the hospital; that is a 26% increase in process efficiency after multiple runs by competition on the same data set.
We got our start long ago auditing healthcare claims to recover trapped assets. More than 30 years of experience became the company Plan2Account, and as a result of the success of our breakthrough technological developments in deep learning analytics and blockchain technology, we’re now Global Care. Our three current divisions are Global Care Analytics and Global Care Audits (formerly Plan2Account).
Global Care Data Monetization conducts 100% payor audits specializing in payment variances and zero-balance accounts for all payor and all specialties. There is no up-front cost and virtually no-risk for the healthcare provider. The benefits from audit and recovery can make a positive financial impact in the current fiscal year.
Our expected results average three percent recovery of annual patient billing, and the net recovery of these revenues goes directly to the bottom line with no additional expense.
Learn how our integrated approach can find the money you need to invest in deep learning analytics
Data Hyper-Ingestion™ (50M claims in under 50 minutes)
Our data engine ingests 100 percent of your transactional claims data for any time horizon (5-7 years recommended) using cloud computing to speed the velocity. Unlike other audit firms and technologies, we hyper-ingest™ 100 percent of all claims and the velocity is astounding: 50 million claims in under 50 minutes with the highest degree of accuracy. We find every penny from every claim, and some are so systemic they can total in the hundreds of thousands of trapped dollars.
Five years of data files are securely sent to Global Care from your healthcare business. As our platform is agnostic, we can receive data and integrate from any EHR system, including Meditech, Cerner, McKesson, Epic Systems, Allscripts, Siemens Healthcare, CPSI, Healthcare Management Systems, Healthland, and Eclipsys. We’re so easy to work with, it’s an IT dream come true.
Contract Hyper-Digestion™ (patented proprietary technology)
We digest all prior and existing contracts using our patented process technology to turn non-intelligent paper and/or PDF contracts into intelligent, or smart contracts. Once this is completed, we use Natural Language Processing (NLP) with a proprietary lexicon, and machine learning AI to make the data within the smart contracts available for analysis. Our platform can now digitally verify the satisfaction of contractual terms against the claim and payment, or lack thereof.
After transmission of your secure data, our team imports your complete provider profile into our highly-secure data system where historical transactions are organized and internal claims validated, with all ICD-9/10 and CPT and DRG codes considered.
Global Care provides you with a detailed Contract Value Analysis report, which includes a comprehensive analysis and onsite review of each and every contract with your hospital or physician group. Underpayments are flagged and an easy-to-understand error report is generated.
Global Care’s AI engine then hyper-digests™ and audits that massive amount of data, comparing it against error codes we have accumulated over the last 25 years.
Our audit recovers trapped assets from underpayment and billing code errors from the payor. This is a by-product of data ingestion, and is a zero upfront cost, elective offering, but why wouldn’t you want trapped assets within zeroed claims found and returned?
We employ our analytics AI to analyze payor and provider contracts, 835s and 837s to reengineer the payment process and historical claims data.
Collect on Trapped Assets
Our team initiates the vigorous process of collecting the identified trapped assets. We do the work for your bottom line. As new error codes are identified, our system applies them to your past and current data. Our monthly reports ensure you don’t once again fall in the trap of lost assets.
You can choose to use the recovered assets to help pay for your investment in our deep learning analytics and blockchain pay system.
Deep Learning Analytics
Analytics are generated from your data (local data) for better informed management, plus we provide instant access to millions of data points in our global data ocean for predictive and comparative analytics. Within the DNA of your claims data there are many latent data points: demographics, procedural, diagnostic, root causation, treatment, efficacy, recidivism, seasonality, associated costs, etc. That data is critical to management and resources planning. The ingestion process provides the foundation for both the audit and recovery, and analytics.