GLIDE HEALTH’s
System of Revenue Intelligence
Our proprietary AI and machine learning technology connects across operations, integrates with practice management, billing and EHR systems to provide targeted guidance to improve revenue and cash flow
Proprietary models built on hundreds of millions of historical claims spanning all major treatments, provider specialties, and major payersSaaS application built on highly scalable AWS cloud and easy API integrations to key EHRs and Practice management systems
Dynamic Denials Prevention (DDP)
Traditional claim scrubbing solutions do a fair job of preventing denials based on static claim formatting rules, but first pass denial rates today still average 15%-20%
Industry averages report that nearly 20 percent of all claims are denied, rejected or underpaid. And considering the cost to rework claims, not to mention even higher appeal costs, as many as 60 percent of returned claims are never resubmitted.
MANAGE PAYER COMPLEXITY
Each payer and plan may have different requirements increasing the complexity of the denial management process.
MACHINE LEARNING ANALYSIS
Making recommendations to manage denials, improve payment recovery and optimize billing
New PAYERS
Glide solution optimizes the appeals’ management process analyzing administrative errors, medical policy changes or payer errors
Intelligent Prior Authorization (IPA)
Identify patient orders that require prior authorization (particularly high value drugs, treatments) based on Glide recommendations
Dynamic Payer Requirements
Payer PA requirements change throughout the year a digital solution helps to keep staff up to date preventing denials
New Treatments
Identifies PA requirements for new treatments including drugs and procedures in real time.
New PAYERS
Identifies new Payers and their PA requirements in real time
Knowledge Sharing
Supports knowledge sharing and financial counselor/billing staff training with a more consistent and dynamically identified set of PA and Claims rules
Manage PA Turnaround Time
Glide forecasts turn around time and alerts when PA timeline is at risk
New Employee\Turnover
Supports new employees from day 1 and reduce turnover impact
SCALE
Glide supports scaling PA efforts and centralization; traditional approaches rely on innate resource knowledge.
METRICS
Includes volume, breakdown by payer, treatment, revenue, turn-around time, a prospective view, etc.