What started as an internal denial improvement project transformed into a comprehensive RCM software suite ready to integrate with any client’s PMS.

For years, Advantum Health’s Revenue Cycle Management team has successfully used their client’s systems to code, bill, and follow up on hospital and physician claims. This approach accelerated implementations and minimized client disruptions, but it required significant training and manual interventions for Advantum’s RCM team. 

As Advantum’s client portfolio grew, so did the revenue cycle team’s need for data integration–it was no longer sustainable for the RCM team to toggle between several disparate systems. 

Advantum’s revenue cycle team needed a robust data management tool to streamline their operations and enable greater scale for their line of business. 

Rather than turn to an outside vendor, Advantum Health leveraged their deep revenue cycle expertise and built the Advantum Ai application. 

Here’s what the Advantum Ai overlay platform is, how it works, and why it changes the game for Advantum Health.

What is Advantum Ai?

“Advantum Ai was created as an internal tool with our front-line staff and development team working hand-in-hand. Over time, the platform has evolved into an integrated suite of powerful applications that streamline workflow, improve accuracy and efficiency, and deliver actionable insight and real-time updates to our clients.” -Tammy Taylor, CEO of Advantum Health

Last year, Advantum Health built and implemented an integrated application suite of tools, Advantum Ai, to support their revenue cycle operations teams and improve their organization’s data management capabilities.

Advantum Health built Advantum Ai with provider excellence in mind. 

Advantum Health tailored their RCM software application toolkit for their centralized revenue cycle teams and quickly realized that the proprietary software would be highly customizable for clients to leverage onsite.

Advantum Ai’s Integrated Application Suite

For the past year, Advantum’s RCM team has fully incorporated the following  Advantum Ai’s integrated modules:

Workflow

Streamline processes through a combination of automation and pre-determined work queues to guide coders, billers, and other RCM staff members through the steps to process hospital claims accurately.

Benefits:

• Improves accuracy 
• Reduces training time
• Minimizes operational variances

 

Charge Entry

Uses a secure and standardized data exchange protocol via HL7 to receive clinical documentation from the client’s PMS, validates coders’ entries, and sends data back to the PMS to get billed.

Leverages a machine learning model with predictive analytics to provide real-time feedback to coders about a claim’s likelihood of getting paid or denied. 

Benefits:

• Improves claim accuracy
• Provides real-time feedback for education and training 
• Reduces denials and write-offs 

Denial Analytics

Acts as a complete Accounts Receivable (AR) work queue and dashboard that allows Advantum’s RCM team to prioritize their daily work based on their clients’ pre-determined criteria. 

Uses bi-directional automation technology to ensure consistency between Advantum Ai and client’s PMS.

Include robust reporting that helps identify the root causes of denials.

Benefits:

• Decreases denials 
• Reduces denial resolution turnaround times
• Streamlines appeals

 

Quality Assurance

A fully integrated quality assurance (QA) tool enables process auditors to randomly sample claim data, create worklists, and track progress.

Benefits:

• Reduces administrative burdens common in QA
• Increases transparency
• Improves overall performance 

How Advantum Ai Works

“Advantum Ai functions as an integrated overlay. The existing practice management platform acts as the source of truth, with Advantum Ai functioning as a component of the ecosystem with only light direct intervention by the provider’s team. We are finding that Advantum Ai is so efficient and intuitive for new users that minimal training is required.” – Jamie Reid, Senior Vice-President of IT Infrastructure and Security at Advantum Health

Advantum Ai acts as an overlay platform and offers Advantum Health’s revenue cycle teams the best of both worlds: system unification and client individualization. 

System Unification

Advantum Ai uses several application programming interfaces (APIs) to connect to different client and internal software systems and pulls data from them. Advantum Ai aggregates the data and presents it to Advantum Health users through a single interface. 

With this new technology, Advantum Health’s coders, billers, and follow-up staff no longer need to log in and out of various systems to execute their core job duties. Instead, Advantum’s RCM team uses one application to support their clients’ revenue cycle needs. 

Client Individualization

Advantum Ai seamlessly integrates with clients’ existing and future Patient Management Systems (PMS) and enables Advantum Health to quickly onboard new clients and achieve faster time to value during project implementations.

Key Features of Advantum Ai’s Overlay Platform:

• Provides Advantum users with an internal, unified platform 
• Integrates with clients’ existing and future Patient Management Systems (PMS)

How Advantum Ai Changed the Game for Advantum

“What started as a denial analytics project turned into a comprehensive RCM software solution that streamlined our team’s processes. Our team doesn’t need to log in and out of several systems or waste time copying and pasting information anymore. They’re able to do almost all of their work in one application.” – Tarun Sharma, Global RCM Product & Automation

Advantum’s RCM staff wanted a “one-stop shop” software solution to process their claims, while their managers needed flexible, real-time performance dashboards. 

In addition, any new technology had to integrate with their clients’ PMS smoothly. 

Their solution? Advantum Ai.

Advantum Ai achieves these goals and more–it leverages automation and machine learning to amplify the quality of Advantum’s client services.

While initially created as an internal software solution, Advantum Ai has become an indispensable RCM tool for Advantum and their clients. 

Advantum combined their deep RCM expertise with cutting-edge technology to produce an integrated and revolutionary suite of applications that streamline workflows, improve accuracy and efficiency, deliver actionable insights, and provide transparent, real-time updates to clients.

To learn more about Advantum Ai, visit advantumhealth.com/technology.