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RAID Healthcare picture 1280WeDo Technologies Healthcare

assure a flawless revenue cycle Management 

There are thousands of ways for revenue leakage in a complex hospital environment: coding inaccuracies, complexity and variation of the contract rules with the insurance companies or government agencies, billing mistakes and successive claims, fraud attempts, system integrations falls, among others. Those cases, one by one, could represent millions in revenue losses in the end of the year and should be properly mitigated and controlled.

RAID:Healthcare software allows the user to stop revenue gaps where and when they happen. Through a continuous controlling process, RAID:Healthcare features are designed to identify revenue leakage and to ensure that the necessary action is performed to protect revenue integrity.


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WeDo Healthcare Revenue Cycle Assurance 1WeDo Healthcare Revenue Cycle Assurance 2

ensure compliance requirements and reduce errors

The healthcare sector is highly regulated, requiring the adoption of control mechanisms to ensure compliance and manage risk. Each medical procedure requires an accurate code registration relying exams, medical treatments, interventions typology, medicines expenses and consumables. Every process needs to be registered and recorded and those face daily human errors and intentional fraud attempts, in most cases justified by an undetected internal control deficiency.

For that, RAID:Healthcare presents a set of process alarms and controls that, through data analysis, allows the user to identify any gaps considering the applicable compliance requirements and calculate the potential costs of non-compliance behaviors. In the end, those actions could be isolated, evaluated and treated.


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WeDo Healthcare Compliance

Cost control and contracts management

A healthcare provider manages multiple services aligned with various types of suppliers. Managing supplier costs requires a specific set of controls to correctly assure that payments are according the contracts and the activity (quantity, price and discount issues).

RAID:Healthcare evaluates the cost associated with each supplier regarding the contract and the activity and identifies excessive costs and payments. This kind of controls are equally applied to control wastage, consume patterns and medical fees.


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WeDo Healthcare Cost Control 1

FRAUD MANAGEMENT AND PREVENTION

Regarding the high budget and the multiplicity of actors, healthcare sector is highly prone to fraud episodes.

An example of how RAID:Healthcare can help is to ensure that the medicines and medical services provided and billed are the ones that have been prescribed by the physician according to the rules established.


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WeDo Healthcare Fraud Detection

USER FRIENDLY DATA MANAGEMENT

RAID:Healthcare collects data from different platforms (medical consultations, emergencies, surgical interventions, billing and inventory) making it possible to process large volumes of data in almost any format. The customized software is capable of reading, processing and enriching the data required in order to display KPI’s results and perform an accurate organizational and financial performance analysis.

RAID:Healthcare delivers a modern interface that boosts productivity by aggregating the key data through a simple, easy-to-use interface that humanizes the User Experience.


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WeDo Healthcare Data Management

Advanced case management

RAID:Healthcare provides an integrated case management feature for improved productivity. The solution uses a rules-based approach for prioritization and reporting based on workflow capabilities for analysts to close cases more efficiently.

RAID:Healthcare Case Management enables analysts to better manage and mitigate organizational risk by sorting and assigning alerts as well as track case resolution progress.


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WeDo Healthcare Case ManagementWeDo Healthcare Case Manegement 2

OUR CUSTOMERS SPEAK FOR US

JMS
As part of its mission and vision to achieve service, operations and systems excellence, José de Mello Saúde uses RAID:Healthcare software to monitor and optimize their revenue stream and achieve a sustainable growth. With more than 70 years-old of experience as a healthcare service provider, JMS currently manages 7 hospitals, 6 clinics and more than 7.000 highly qualified professionals.

WATCH HOW YOUR HEALTHCARE BUSINESS CAN BENEFIT FROM
AN ENTERPRISE BUSINESS ASSURANCE APPROACH

 

BEST STRATEGIES TO IMPROVE REVENUE CYCLE EFFICIENCY IN HEALTHCARE

By Jose Xavier | Vice President for North America & Caribbean region at WeDo Technologies

We are in the midst of one of the most critical points in time for medical revenue cycle management in the U.S.. The pace of change is dizzying- whether it’s HIPAA compliance, Electronic Medical Records (EMR) or the new health exchanges on the market, things have never been more complex, and the risk for error never higher.

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Blog Healthcare
 

LEARN MORE ABOUT REVENUE CYCLE MANAGEMENT FOR HEALTHCARE

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