Health systems constantly struggle to ensure the accuracy of medical claims. Inefficiencies in hospital billing practices coupled with overwhelming patient volume and manual intervention makes it difficult to accurately bill for services rendered. This often results in missed charges and claim denials, directly impacting the bottom line. Traditional rule-based solutions are static in nature, are costly to scale, and lead to much higher false positives.

 

Opera Solution’s Revenue Cycle AI helps hospitals significantly increase profitability and operating efficiencies by identifying missing charges and reducing audit expenses.

 

Our pattern-based machine learning approach utilizes predictive modeling, anomaly detection, and other advanced analytics techniques to dynamically detect patterns and continuously learn from audit results in real time. This unique approach leads to highly accurate predictions that improve over time.

 

  • Separate modules for health systems and physician groups
    • Deployed by 200+ hospitals
    • Covering 5,000+ physicians (and counting!)
  • Adds 25–75 basis points in revenue on top of existing systems. 
  • System agnostic and easily integrated with various EMR systems - EPIC, Meditech, and McKesson