It’s all about the essentials
Together, we’ll hit the ground running by evaluating your data while learning about your commitments. Your data will be handled securely and in compliance with HIPAA. We’ll learn how to interpret your unique claims and provider data and incorporate how you address your company’s line of business policies, provider contracts, industry standards (NCCI, HCPCS, CPT), state guidelines, the Centers for Medicare and Medicaid Services (CMS) regulations – and more.
You Provide
- Ongoing data feed
- Configuration checklist of business requirements
We Deliver
- AArete best-in-class methodology and market intelligence
It’s all about building in quality
During this time, the AArete team is leveraging your data using Payment Intelligence® to build quality and consistency with your business requirements. Using rules-based analytics and artificial intelligence (AI), AArete configures rules and develops unique models to support your needs.
You Provide
- Business requirements calls for additional clarifications
We Deliver
- Subject matter experts to manage and monitor the rules and models
- Data enrichment
- Quality assurance testing
- Vetting of initial results
Phase Three
It’s all about getting it right
Together, we’ll fine-tune the Payment Intelligence® edits and models, testing each and every individual change. Getting it right for you is essential to your success. At the end of this phase, you are ready to begin to gain value from your investment.
You Provide
- Testers for user acceptance
- Scrub calls for feedback
- Validation of opportunities
We Deliver
- Finely-tuned models & edits
- Robust reporting & results measurement
It’s all about optimizing results
We continue to add new layers of intelligence with additional models. Ultimately, helping you achieve a steady state through the ongoing identification of actionable findings to maximize the return on your investment.
You Provide
- Decisions for automated acceptance
- Ongoing feedback & review of findings
- Adjust claims for opportunities
We Deliver
- Subject matter expertise
- Ongoing presentation of recoupable findings
- Machine learning & additional models
- Insights into optimization
- Root cause remediation
