Revenue Cycle Management

Sagility delivers unprecedented results in Revenue Cycle Management (RCM) by combining people, processes, and technology. We use EMR and HIS-driven predictive analytics and machine learning to prioritize unpaid claims based on their propensity to pay, utilizing smart automation to enhance claims accuracy and increase speed-to-pay. 

 

  • Managed over $18.4 billion in client accounts receivable
  • $5.1 billion in cash recovered
  • Processed over 60 million hospital, physician, and DME claims
  • Reversed more than 9 million zero-paid denials, recovering $1.4 billion

 

Contact us now to explore our full suite of services, including A/R Management and Denials Management.

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A/R Management

With the help of machine learning algorithms, Sagility works with predictive analytics to help our clients stay ahead of the curve. These are designed to analyze and prioritize unpaid claims based on their likelihood of payment. Our advanced root-cause analysis aids in the correction of claim inaccuracies, which improves cash collections at a reduced price point.

 

  • – Aged A/R resolution and legacy A/R wind-down
  • – Early-out/small balance claims resolution
  • – Specialty A/R management
  • – Process optimization for increased recovery rates

Denials Management

A targeted, tech-driven approach to revenue recovery. By utilizing AI and sophisticated analytics, we can accurately identify the root causes of denials. This information informs our corrective strategies, which are efficiently implemented through intelligent automation processes. We specialize in Clinical Denials Management, focused on resolving clinical denials and ensuring no avenue for revenue recovery is overlooked.

 

  • – Expert talent with both clinical and coding backgrounds
  • – Smart automation processes to efficiently implement corrective measures
  • – Clinical Denials Management for clinical issue resolution
  • – Comprehensive strategy that maximizes the potential for revenue recovery
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Achieving A/R Reduction for Nearly 90% Resolution

 Sagility assists a healthcare client in resolving high-aged, complex AR claims, resulting in significant reductions and successful cash collection through systematic problem-solving.

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US hospital system achieves 80+% overturn of denials

Amid the pandemic, a prominent US healthcare provider faced challenges with low overturn rates of claim denials. Partnering with Sagility, they implemented a comprehensive solution that delivered exceptional results.

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