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Cognizant Revenue Cycle Management

Optimize claims realization ratio, reduce denial rates, and improve processing times

Cognizantโ€™s RCM process-mining solution will help improve Revenue Cycle Management process, which generally covers medical coding, charge entry, claim submission, accounts receivable and appeals.

This is where Cognizant and Celonis Combine their Strengths

Cognizantโ€™s RCM Process Mining solution incorporates our insights and best practices from serving health care providers into a process mining tool including:

  • KPI metrics and diagnostic visualizations based on best practices developed from our RCM BPO services

  • Models that predict likely outcome (either approvals or denials) to automatically route cases for expedited and efficient processing

  • Normative process model and benchmarks based on our experience performing RCM BPO services for clients

Features & Capabilities

Representation of key KPIs namely Revenue Impact and efficiency Impact

Cognizant - Management Dashboard

Representing Claim Denial trend over period of time, additional insights about claim denial by providers/Payer/Group/Reason code.

Cognizant - Claim Denial Rate

Propensity of claim getting denied based on expected amount, procedure code ID, provider ID etc.

Cognizant - Claim Denial Prediction Model

AR prioritization summary based on aging, priority business rule etc. built-in filters.

Cognizant - AR Prioritization
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Cognizant - Management Dashboard
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Cognizant - Claim Denial Rate
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Cognizant - Claim Denial Prediction Model
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Cognizant - AR Prioritization

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