Joseph O'Donnell

Unlike traditional retrospective methods, our Chronic Risk Adjustment solution allows payers to intervene earlier, ensuring that chronic conditions are accurately captured before claims are submitted. The benefits are twofold – improving care and reducing administrative waste by ensuring the claim is submitted correctly the first time.

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In today's fast-evolving landscape of #PaymentIntegrity, the importance of prepay editing is more crucial than ever. With AI and advanced analytics being applied earlier in the claims process, next-generation claim editing capabilities will distinguish health plan leaders from the rest. In our latest blog below, our VP of Clinical Content Mark Turner dives into why prepay editing is a game-changer for health plans. Here's a sneak peek: 1. It helps organizations stay agile with regulatory updates. 2. It reduces administrative expenses, and conserves resources, impacting overall economic outcomes positively. 3. It can help organizations avoid the costs of post-payment corrections. 4. It reduces provider abrasion and improves relationships. Learn more about the power of prepay #ClaimsEditing at the link below ⬇️ #SimplifyingCare #SimplifyingtheBusinessofCare

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Payers have been using big data for years. It's time the provider side uses AI to level the playing field to better manage denials and the revenue cycle. Today's blog discusses how to find and fix denials with AI. https://hubs.la/Q02XngNt0 #RCMAnalytics #HealthcareDenials

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Payers are seeking new risk assessment tools to improve commercial underwriting accuracy and gain a competitive edge. Find out how these tools are evolving to evaluate risk better and set competitive premium rates. Read the article here: https://optumin.co/0iqu74   #Optum #healthplans #Payers #Underwriting #Riskassessment #healthcareanalytics #actuarial #predictivepower #riskevaluation

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Payers are seeking new risk assessment tools to improve commercial underwriting accuracy and gain a competitive edge. Find out how these tools are evolving to evaluate risk better and set competitive premium rates. Read the article here: https://optumin.co/0iqu74    #Optum #healthplans #Payers #Underwriting #Riskassessment #healthcareanalytics #actuarial #predictivepower #riskevaluation

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The devil is in the details. Learn why record retrievals for HEDIS and Risk can be challenging and how Inovalon solutions help

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We just announced a sneak preview of the next big thing for our practice product: DSO Analytics  What is it you may ask? This is the first AI-powered analytics suite built specifically for DSO’s. It enables executives to transform mountains of data into actionable insights to improve their organization’s performance, from case acceptance and productivity rates to treatment planning efficiency. Leaders can get a comprehensive view of their entire organization or drill down to see the performance of a clinic or specific provider level to uncover opportunities for education to improve patient care. In short, it’s a game changer for DSO leaders.https://https://lnkd.in/eKP6QKJb

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Connect the dots..... between People Process Product Technology & Business Unit Economics. There's no magic bullet. It's that simple and that hard. Over the past few weeks, I've had this conversation on repeat with Founders, CEOs and other GTM leaders. It's like Groundhog Day living rent free in my head. What's on repeat in your world?! #GTM #leadership #revenuegrowthengine

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According to a recent survey, 67% of healthcare leaders said that "denials, audits, and takebacks" were their top revenue cycle management (RCM) concern. Predictive artificial intelligence (AI) technology solutions can help identify the insurance claims that are likely to be denied while generative AI can streamline denials correspondence through automated letter generation that supports a dental practice's original claims. My team and I help leading U.S. dental support organizations (DSOs) and their affiliated practices harness the power of AI and machine learning to automatically generate detailed insurance claim denial analytics reports. Our intelligent claim denial management software automatically categorizes denied claim line items with recommended actions on how to best handle them. The enterprise software includes user-friendly out-of-the-box as well as fully customizable dental RCM data visualization dashboards with detailed metrics reporting by individual office location, operating region, as well as organization-wide. Has your U.S. DSO or dental practice modernized its revenue cycle operations with AI to reduce insurance claim denials and maximize cash collections? #healthcare #dental #revenuecyclemanagement #artificialintelligence

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KPI the most comprehensive view of patient insurance status available, encompassing over 200 million de-identified U.S. patient lives. Eager to learn more? Lucky for you, it's not too late to register for tomorrow's webinar 🙌 (Thursday, June 27, at 12 p.m. ET) Check the comments for the registration link 👇 #payeranalytics #KPI #komodopatientinsurance #patientinsurance #dualeligible #marketaccess

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KeyCorp (NYSE: KEY) today announced a strategic relationship, which includes a minority investment, with Zentist, the leading cloud-based insurance revenue cycle management (RCM) software provider to dental support organizations (DSOs) and their affiliated practices across the United States. KeyBank will introduce Zentist's Remit AI RCM software to its extensive network of DSOs, providing them with access to a transformative tool that enhances their dental revenue cycle operations. Remit AI streamlines dental insurance claims processing with features that include automated explanation of benefits (EOB) parsing and electronic remittance advice (ERA/835) data delivery, automated remittance to bank deposit matching, and intelligent task distribution across both centralized and decentralized DSO structures. The modern dental RCM software also includes specialized predeterminations workflows, real-time claim status updates, and fully customizable advanced RCM analytics dashboards. "KeyBank's commitment to delivering comprehensive financial solutions to DSOs as part of a broader healthcare strategy that involves helping clients with the whole spectrum of payments capabilities and with industry-specific financial services and solutions," said Jon Briggs, Head of KeyBank Commercial Payments and Innovation. "Our strategy aligns perfectly with Zentist's mission to simplify and improve the financial operations of dental groups and practices." "KeyBank is one of the most innovative banks in the country, and we're thrilled to have them as both an investor and a new fintech bank relationship," said Ato Kasymov, CEO & Co-founder of Zentist. "This relationship will allow us to reach a wider audience and help dental groups to optimize their revenue cycles, ultimately leading to better financial health and patient care." KeyCorp's roots trace back nearly 200 years to Albany, New York. Headquartered in Cleveland, Ohio, Key is one of the nation's largest bank-based financial services companies, with assets of approximately $187 billion at June 30, 2024. Key provides deposit, lending, cash management, and investment services to individuals and businesses in 15 states under the name KeyBank National Association through a network of approximately 1,000 branches and approximately 1,300 ATMs. Key also provides a broad range of sophisticated corporate and investment banking products, such as merger and acquisition advice, public and private debt and equity, syndications, and derivatives to middle market companies in selected industries throughout the United States under the KeyBanc Capital Markets trade name. Contact me to learn more. #healthcare #dentistry #revenuecyclemanagement #fintech #banking #finance #artificialintelligence #technology #innovation

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I am excited to share the latest episode of Deep, The Health Marketing Podcast! This episode we discuss EHR and how the industry uses EHR to improve health outcomes. Damon Basch shares his years of experience and personal insights from his amazing journey.

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Need to lower the cost of recovering denied claims? AI is already helping 1,300+ WhiteSpace Health clients do just that. Learn how in today's blog, penned by our VP of marketing, Carrie Bauman. https://hubs.la/Q02XncBh0 #RCMAnalytics #HealthcareAI #DenialRecoveryAI

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2024 has gotten off to a somewhat shaky start, with news of layoffs, longer sales cycles, and a slowdown in hiring. It is not all gloom and doom, however, with some encouraging signs from a technological advancement and funding standpoint! Despite the uncertainty, the future is very bright for health companies that harness the power of AI. The healthcare landscape in 2024 will be marked by significant technological advancements and a shift towards preventive care. Staying current with these trends will be crucial for healthcare providers to navigate the evolving environment and leverage new opportunities for improved patient care and operational efficiency. AI and IoT innovations are set to transform healthcare, but organizations must navigate evolving regulatory landscapes and ensure robust data protection and privacy measures. Great breakdown by 🚀Alex Hutchings on the future of #sales #ai #healthcare #hiring ✅ https://lnkd.in/eEwBMRxA

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Clearwave's Multi-Factor Eligibility capability helps practices improve collections, reduce claim rejections, accelerate cash flow, and ramp up staff productivity: 112% increase in point-of-service collections.  94% drop in claim rejections due to the mitigated risk of human error.  65% acceleration in cash flow.  2x drop in staff workloads for eligibility verification.

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Overjet's Insurance Intelligence Platform just got even better 🎉 Introducing... Overjet Connect: an AI-powered marketplace that connects insurers with licensed clinical reviewers to seamlessly scale their utilization review process. It's a huge addition to our platform that is going to help insurers provide millions of members with expert quality decisions 5x faster. Faster, more consistent decisions = happy members and even happier clinicians 😁 Read more about it in our press release below.

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This week’s announcement of lowered prices for 10 negotiated drugs is projected to save Medicare billions, marking a positive step forward. However, there remains significant work ahead to tackle the root causes of escalating drug prices and out-of-pocket expenses for patients. It will be interesting to watch how the pharma value chain adapts to this shift in the coming months and the impact on patient out-of-pocket costs. [Link to the article for more details: https://lnkd.in/e_7wKpyb] #Medicare #healthcare #pharma #pricing #innovation

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Catch this webinar replay! With upcoming requirements that help streamline and automate prior authorization, the industry is facing considerable challenges to scale connectivity between payers and providers rapidly. During this webinar, leading experts from Itiliti Health and eHealth Exchange discuss the best ways to create scalable connectivity between healthcare providers and payers. Watch here: https://lnkd.in/g58CHky5 #priorauth #priorauthorization #AIinHealthcare

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