You Have Questions? We Have Answers.


What do you need to know to inform your decision? Check out some of the questions and answers below to help you understand how AArete’s Payment Intelligence®, powered by the Ida™ workbench, can help you.

Product Features

What does the Payment Intelligence® product do?

The Payment Intelligence® Ida™ workbench goes beyond the simple payment policies approach used by payment integrity vendors. We identify claims recovery opportunities, as well as configuration edits to address errors around member eligibility, covered benefits, contracts, provider data, payment policies and prior authorizations.

PRODUCT FEATURES

Does it help manage provider data?

Yes, Payment Intelligence® can provide you with transparency into the accuracy of your provider data. With the No Surprises Act requirements, we know this is an area of concern. We validate and verify that configured information matches source documents, including provider-sourced information (such as rosters, ACT files, contracts) and third-party information (such as AArete Intelligence® , NPPES, Google).

PRODUCT FEATURES

How does machine learning help?

If not carefully managed, artificial intelligence can provide a lot of false positives. Our Payment Intelligence ® process relies on machine learning to ensure that findings continue to improve when presented and prepared for each client. This helps to ensure any manual reviews conducted by your team are minimized over time to reflect just the changes with the highest probability of acceptance.

PRODUCT FEATURES

How do you remove false positives?

AArete’s process to minimize false positives has been honed across many client projects, resolving the issues driving their claims payment inaccuracies. By bundling our market intelligence and subject matter expertise with machine learning, we provide you with the Payment Intelligence® Ida™ workbench that minimizes false positives.

PRODUCT FEATURES

How is AArete better at Artificial Intelligence (AI)?

Artificial intelligence is great at predicting anomalies in delivery of care and in payment. Not all that AI identifies is actionable. While other vendors may offer AI-based services, Payment Intelligence® focuses on only presenting actionable findings to our clients, adapted to the level of review our clients want to conduct. For other findings, our consultants can supply alternative strategies to address those recoveries and needs.

PRODUCT FEATURES

What is “root cause analysis?”

AArete’s Payment Intelligence® team consists of business consultants and subject matter specialists who go deeper by finding the root cause of issues. We identify the driver, whether its people, process, or technology and recommend the appropriate fix. We work closely with our clients to ensure the recommendation effectively eliminates the payment error.

Services & Support

Do you help with implementation?

Yes, AArete has created Ida™, a workbench solution, that combines Payment Intelligence® analytical technology with services that leverage our deep expertise in management consulting to help our clients implement an approach for claims recovery and root cause fixes. These fixes can often be applied directly to your adjudication or provider data management systems.

Services & Support

Do you provide appeals support?

Yes, AArete reviews the appeals and provides responses for our clients to pass along to providers.

Services & Support

Does AArete perform recoveries?

AArete does not perform recoveries or collections, but can help find a partner that does. AArete can assist in settlement negotiations or in improving existing recovery workflows.

Services & Support

What is the expected set-up time?

Through our onboarding process, we aim to have clients up and running within 90 days of receipt of claims data and configuration set-up materials. We use your company policies and contractual obligations to build in quality as we set up the Ida™ workbench. We begin vetting findings with clients 30-45 days after receipt of the data. We continue to test and finetune until we get it right, while the users are being trained on how to conduct reviews and use the system. Once the test process is complete, we provide logins and the users are ready to go.

Product Features

What is Ida™? What is the workbench?

AArete’s Ida™ is a cloud native SaaS solution housing AArete’s Payment Intelligence® solution, custom designed for healthcare payer clients to manage live claims data with ease.

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