Cognizant’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
Cognizant’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
Representation of key KPIs namely Revenue Impact and efficiency Impact
Representing Claim Denial trend over period of time, additional insights about claim denial by providers/Payer/Group/Reason code.
Propensity of claim getting denied based on expected amount, procedure code ID, provider ID etc.
AR prioritization summary based on aging, priority business rule etc. built-in filters.
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