A physician-owned and led multispecialty group in Illinois faced inadequate accounts receivable (A/R) reporting and analytics that limited its ability to analyze trends in rising denial rates across more than 200 facilities
The organization contacted AGS Health to seek support for A/R and denial management services, complemented by a denial dashboard and insight report.
Challenge
- A significant rise in the number of denied claims.
- Difficulty in interpreting A/R metrics due to data fragmentation across multiple reports.
- Inability to identify and process the sudden spike in denials.
Solution
AGS Health’s analytics engineers developed a comprehensive analytics dashboard specifically designed to help the organization manage denials. The interactive tool offers insightful data visualizations through data models, along with in-depth denial analytics to understand root causes. It also provides prescriptive analytics with data-driven recommendations to proactively prevent recurring denials.
The dashboard leverages real-time analysis capabilities and complex business rules embedded within its Structured Query Language (SQL) data models to ensure accurate trend analysis. AGS Health service representatives continuously monitor metrics to detect sudden spikes in denials, allowing for immediate intervention.
Following the success of this initiative, the organization enlisted AGS Health to support the development of a customized dashboard for its coding operations.
7% increase in clean claims
15+ A/R metrics tracked and trended
Decreased front end eligibility denials
