|By Business Wire||
|November 5, 2012 11:16 AM EST||
SAI Global Compliance, the world’s leading provider of governance, risk and compliance (GRC) products, services and technology, including the Compliance 360® software suite, today announced a new application for healthcare providers, Claims Denial Manager, specifically designed to help minimize revenue loss due to pre-payment claims denials, primarily from commercial payers. Also announced are significant enhancements to its industry-leading Claims Audit Manager application, also for healthcare providers.
Amidst increasing government audits aimed at reducing erroneous billing in the Medicare and Medicaid programs, as well as increasing claims payment denials from private insurance carriers, the revenues and profits of healthcare providers face unprecedented challenges. SAI Global is providing new, advanced systems to help healthcare providers address all of these financial risks.
Today, thousands of healthcare facilities across the United States are using the Compliance 360 Claims Audit Manager to minimize revenue loss by ensuring that legitimate claims are not caught up in increasingly aggressive government audit programs. The Claims Audit Manager functions as a “Virtual Audit Coordinator,” enforcing deadlines and due dates throughout the healthcare organization and providing alerts to ensure effective management of complex appeals processes and avoidance of automatic revenue recoupment. The enhanced Claims Audit Manager increases the level of automation and includes a new underlying architecture that enables a higher degree of configuration by the customer, including the ability to customize application forms and add customer-specific data fields. The enhancements also include a variety of pre-configured reports as well as a new graphical report layout designer for easily creating custom reports.
Based on the same powerful platform and leveraging years of experience and success with the widely proven Claims Audit Manager, SAI Global is also introducing the new Claims Denial Manager application. Managing pre-payment claims denials, such as those common from commercial payers, is a significant challenge for many healthcare providers. Industry statistics indicate that healthcare providers write-off 3 to 5 percent of net revenue due to denials because they lack a comprehensive denials management program. This can equate to millions of dollars in potentially recoverable revenue for the average hospital. With most providers submitting claims to multiple payers, identifying denials, analyzing the claims to determine root causes, collecting information to support a resubmission or appeal and implementing cross-departmental process improvements is impractical without automation. The new Claims Denial Manager solution is designed to help providers manage the claims denial process with the tools needed to quickly identify and analyze denied claims, increase accountability and ultimately improve net revenue capture.
“Market acceptance of our Claims Audit Manager application has been outstanding,” said Steve McGraw, GRC president, SAI Global Compliance. “We estimate that our hospital customers have successfully appealed claims audit denials totaling $40 million in legitimate revenues with the support of our Claims Audit Manager, and substantially more is pending in active appeals. Based on this success and specific requests from our customers, we’ve developed the new Claims Denial Manager application. Used in combination with the Compliance 360 Claims Audit Manager application, healthcare providers will have the complete visibility needed to monitor and proactively manage all of their financial exposure stemming from pre-payment and post-payment claims audits and denied claims.”
According to Dr. Larry Hegland, chief medical officer for Ministry Health Care, “Payment denials from health insurance organizations are a constant challenge, creating additional pressure on the bottom line for most healthcare providers. As both sides of this equation strive to maintain revenues and margins, we expect to see increasing challenges from claims payment denials. We are glad to see that SAI Global has leveraged the experience gained with their widely deployed solution for managing RAC, MIC and other government-driven revenue audits to design and deliver this new application for managing pre-payment denials.”
The enhanced version of the Claims Audit Manager and the new Claims Denial Manager application are both generally available now from SAI Global. A broadcast demonstration of the Claims Denial Manager application is scheduled for Nov. 28, 2012, at 2:00 p.m. EST. Visit www.compliance360.com/webdemos for more details.
About Compliance 360® GRC Software Suite
The original Governance, Risk and Compliance (GRC) software solutions born in the cloud, Compliance 360 brings order and efficiency to the complexity of enterprise governance, risk management, compliance and audit management. The Compliance 360 GRC Software Suite includes regulatory compliance software, policy management software, internal audit software, incident management software, ERM software and a wide variety of specialty applications. More than 250,000 professionals every day in financial services, insurance, healthcare, distribution and other regulated industries rely on Compliance 360 applications to help protect their revenues, reputations and brands. www.compliance360.com
About SAI Global Compliance
SAI Global Compliance provides organizations with a wide range of governance, risk and compliance (GRC) products, solutions and services that help build organizational integrity and meet overall business objectives. With more than 25 years experience and offices in more than 25 countries, SAI Global’s solutions include a wide range of GRC products and services, including the Compliance 360 GRC Software Suite, best practice Code of Conduct program services and training, compliance and ethics training and awareness, risk and culture assessments, a full range of advisory services, whistleblowing hotline services, regulatory knowledge, policy management, case management and third-party compliance management, including automated due diligence workflow and management. www.saiglobal.com/compliance
SYS-CON Events announced today that Super Micro Computer, Inc., a global leader in Embedded and IoT solutions, will exhibit at SYS-CON's 20th International Cloud Expo®, which will take place on June 7-9, 2017, at the Javits Center in New York City, NY. Supermicro (NASDAQ: SMCI), the leading innovator in high-performance, high-efficiency server technology, is a premier provider of advanced server Building Block Solutions® for Data Center, Cloud Computing, Enterprise IT, Hadoop/Big Data, HPC and ...
Oct. 24, 2016 01:00 AM EDT Reads: 3,569
SYS-CON Events announced today that SoftNet Solutions will exhibit at the 19th International Cloud Expo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. SoftNet Solutions specializes in Enterprise Solutions for Hadoop and Big Data. It offers customers the most open, robust, and value-conscious portfolio of solutions, services, and tools for the shortest route to success with Big Data. The unique differentiator is the ability to architect and ...
Oct. 24, 2016 01:00 AM EDT Reads: 762
In past @ThingsExpo presentations, Joseph di Paolantonio has explored how various Internet of Things (IoT) and data management and analytics (DMA) solution spaces will come together as sensor analytics ecosystems. This year, in his session at @ThingsExpo, Joseph di Paolantonio from DataArchon, will be adding the numerous Transportation areas, from autonomous vehicles to “Uber for containers.” While IoT data in any one area of Transportation will have a huge impact in that area, combining sensor...
Oct. 24, 2016 12:45 AM EDT Reads: 745
In the next forty months – just over three years – businesses will undergo extraordinary changes. The exponential growth of digitization and machine learning will see a step function change in how businesses create value, satisfy customers, and outperform their competition. In the next forty months companies will take the actions that will see them get to the next level of the game called Capitalism. Or they won’t – game over. The winners of today and tomorrow think differently, follow different...
Oct. 24, 2016 12:45 AM EDT Reads: 959
“Media Sponsor” of SYS-CON's 19th International Cloud Expo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. CloudBerry Backup is a leading cross-platform cloud backup and disaster recovery solution integrated with major public cloud services, such as Amazon Web Services, Microsoft Azure and Google Cloud Platform.
Oct. 24, 2016 12:45 AM EDT Reads: 1,335
More and more brands have jumped on the IoT bandwagon. We have an excess of wearables – activity trackers, smartwatches, smart glasses and sneakers, and more that track seemingly endless datapoints. However, most consumers have no idea what “IoT” means. Creating more wearables that track data shouldn't be the aim of brands; delivering meaningful, tangible relevance to their users should be. We're in a period in which the IoT pendulum is still swinging. Initially, it swung toward "smart for smar...
Oct. 24, 2016 12:15 AM EDT Reads: 867
@ThingsExpo has been named the Top 5 Most Influential M2M Brand by Onalytica in the ‘Machine to Machine: Top 100 Influencers and Brands.' Onalytica analyzed the online debate on M2M by looking at over 85,000 tweets to provide the most influential individuals and brands that drive the discussion. According to Onalytica the "analysis showed a very engaged community with a lot of interactive tweets. The M2M discussion seems to be more fragmented and driven by some of the major brands present in the...
Oct. 23, 2016 11:45 PM EDT Reads: 11,348
Successful digital transformation requires new organizational competencies and capabilities. Research tells us that the biggest impediment to successful transformation is human; consequently, the biggest enabler is a properly skilled and empowered workforce. In the digital age, new individual and collective competencies are required. In his session at 19th Cloud Expo, Bob Newhouse, CEO and founder of Agilitiv, will draw together recent research and lessons learned from emerging and established ...
Oct. 23, 2016 11:00 PM EDT Reads: 1,269
The best way to leverage your Cloud Expo presence as a sponsor and exhibitor is to plan your news announcements around our events. The press covering Cloud Expo and @ThingsExpo will have access to these releases and will amplify your news announcements. More than two dozen Cloud companies either set deals at our shows or have announced their mergers and acquisitions at Cloud Expo. Product announcements during our show provide your company with the most reach through our targeted audiences.
Oct. 23, 2016 10:30 PM EDT Reads: 4,576
DevOps is being widely accepted (if not fully adopted) as essential in enterprise IT. But as Enterprise DevOps gains maturity, expands scope, and increases velocity, the need for data-driven decisions across teams becomes more acute. DevOps teams in any modern business must wrangle the ‘digital exhaust’ from the delivery toolchain, "pervasive" and "cognitive" computing, APIs and services, mobile devices and applications, the Internet of Things, and now even blockchain. In this power panel at @...
Oct. 23, 2016 09:45 PM EDT Reads: 1,867
November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. Penta Security is a leading vendor for data security solutions, including its encryption solution, D’Amo. By using FPE technology, D’Amo allows for the implementation of encryption technology to sensitive data fields without modification to schema in the database environment. With businesses having their data become increasingly more complicated in their mission-critical applications (such as ERP, CRM, HRM), continued ...
Oct. 23, 2016 09:15 PM EDT Reads: 984
Explosive growth in connected devices. Enormous amounts of data for collection and analysis. Critical use of data for split-second decision making and actionable information. All three are factors in making the Internet of Things a reality. Yet, any one factor would have an IT organization pondering its infrastructure strategy. How should your organization enhance its IT framework to enable an Internet of Things implementation? In his session at @ThingsExpo, James Kirkland, Red Hat's Chief Arch...
Oct. 23, 2016 09:00 PM EDT Reads: 5,992
SYS-CON Events announced today that Enzu will exhibit at the 19th International Cloud Expo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. Enzu’s mission is to be the leading provider of enterprise cloud solutions worldwide. Enzu enables online businesses to use its IT infrastructure to their competitive advantage. By offering a suite of proven hosting and management services, Enzu wants companies to focus on the core of their online busine...
Oct. 23, 2016 08:45 PM EDT Reads: 1,288
Why do your mobile transformations need to happen today? Mobile is the strategy that enterprise transformation centers on to drive customer engagement. In his general session at @ThingsExpo, Roger Woods, Director, Mobile Product & Strategy – Adobe Marketing Cloud, covered key IoT and mobile trends that are forcing mobile transformation, key components of a solid mobile strategy and explored how brands are effectively driving mobile change throughout the enterprise.
Oct. 23, 2016 08:30 PM EDT Reads: 1,721
SYS-CON Events announced today that Cloudbric, a leading website security provider, will exhibit at the 19th International Cloud Expo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. Cloudbric is an elite full service website protection solution specifically designed for IT novices, entrepreneurs, and small and medium businesses. First launched in 2015, Cloudbric is based on the enterprise level Web Application Firewall by Penta Security Sys...
Oct. 23, 2016 08:30 PM EDT Reads: 1,108
SYS-CON Events announced today that Roundee / LinearHub will exhibit at the WebRTC Summit at @ThingsExpo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. LinearHub provides Roundee Service, a smart platform for enterprise video conferencing with enhanced features such as automatic recording and transcription service. Slack users can integrate Roundee to their team via Slack’s App Directory, and '/roundee' command lets your video conference ...
Oct. 23, 2016 07:30 PM EDT Reads: 2,073
Established in 1998, Calsoft is a leading software product engineering Services Company specializing in Storage, Networking, Virtualization and Cloud business verticals. Calsoft provides End-to-End Product Development, Quality Assurance Sustenance, Solution Engineering and Professional Services expertise to assist customers in achieving their product development and business goals. The company's deep domain knowledge of Storage, Virtualization, Networking and Cloud verticals helps in delivering ...
Oct. 23, 2016 06:45 PM EDT Reads: 1,013
SYS-CON Events announced today that Embotics, the cloud automation company, will exhibit at the 19th International Cloud Expo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. Embotics is the cloud automation company for IT organizations and service providers that need to improve provisioning or enable self-service capabilities. With a relentless focus on delivering a premier user experience and unmatched customer support, Embotics is the fas...
Oct. 23, 2016 04:30 PM EDT Reads: 814
In the next five to ten years, millions, if not billions of things will become smarter. This smartness goes beyond connected things in our homes like the fridge, thermostat and fancy lighting, and into heavily regulated industries including aerospace, pharmaceutical/medical devices and energy. “Smartness” will embed itself within individual products that are part of our daily lives. We will engage with smart products - learning from them, informing them, and communicating with them. Smart produc...
Oct. 23, 2016 04:15 PM EDT Reads: 1,480
As ridesharing competitors and enhanced services increase, notable changes are occurring in the transportation model. Despite the cost-effective means and flexibility of ridesharing, both drivers and users will need to be aware of the connected environment and how it will impact the ridesharing experience. In his session at @ThingsExpo, Timothy Evavold, Executive Director Automotive at Covisint, will discuss key challenges and solutions to powering a ride sharing and/or multimodal model in the a...
Oct. 23, 2016 03:30 PM EDT Reads: 1,495