DenialsNavigator™ is a unified denials management solution that combines automated workflows, comprehensive reporting and root cause analysis to streamline your process and reduce denial rates. Key benefits of DenialsNavigator™ include:

• Support for all denials – institutional and professional for all payers
• Both claim and line level denial monitoring and reporting
• Workflows reduce staff time and lower days in A/R
• Root cause analysis facilitates training and education efforts and prevents future denials
• Easy to understand dashboards allow you to quickly monitor in-process activity

AuditNavigator™ is the next generation audit and appeal system that enables you to move from just tracking to automating many of the manual processes previously performed by your staff. AuditNavigator™ gathers information from commercial payer portals, RAC websites, the Medicare/FISS system, remittance files, and uses this information to automatically populate new audits as well as update the status and financial information for existing audits. Automating these processes frees up staff time for other needs and reduces costs.

DataNavigator is a comprehensive and interactive business intelligence (BI) platform designed to assist multiple departments in the revenue cycle to develop keen insights into their data to make faster and better decisions. Departments benefitting from this tool are:

• Revenue Cycle- Identify and monitor at the line-level combinations of root-causes, departments, physicians, medical coder, payers and others involved in both denials and audits.
• Health Information Management (CDM)- Identify the frequency and dollars associated with coding mismatches amongst multiple code sets (DRG, procedure, HCPCs, diagnosis, etc.).
• Compliance- Identify potential exposure to targeted external audits- i.e. If payers initiate audits based upon certain scenarios you’ll be able to identify potential financial exposure.
• Payer Contracting- Identify the specific payer types. For example, your able to identify certain issues that are associated with Humana, but by interacting with the data and drilling-down further your able to identify that Humana Gold is the actual offending payer.

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