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Description
CoverSelf has developed an advanced, cloud-native claims accuracy platform tailored specifically for the healthcare sector, utilizing cutting-edge software development practices. This innovative solution supports users in achieving sustained success by adapting seamlessly to the continual changes in claims and payment inaccuracies, thereby minimizing challenges and administrative expenses. By allowing open collaboration among all partners focused on tackling claims discrepancies and operational inefficiencies, the platform enables faster customization, innovation, and deployment. Additionally, CoverSelf’s payment integrity system leverages contemporary technologies to resolve payment leaks and inaccuracies while maintaining a high level of transparency and accessibility for payers. The platform fosters the creation of novel scenarios and data mining algorithms, driving product innovation and accelerating customization efforts, all within a specialized framework that enhances the speed of innovation. Furthermore, it automates the correction and processing of claims, eliminating the need for further human intervention or effort, thus streamlining operations even more efficiently. This comprehensive approach not only optimizes the claims process but also significantly contributes to improving overall healthcare operations.
Description
PwC's SMART (Systematic Monitoring and Review Technology) enhances both the efficiency and effectiveness of evaluating the quality of inpatient and outpatient coding processes while establishing a framework for quality assurance and compliance reviews. In conjunction with the support from PwC Health Information Advisory, SMART reinforces your strategy for monitoring coding accuracy and overall data quality. The SMART Inpatient module features over 1,000 established business rules designed to uncover potential coding errors and opportunities for documentation enhancement, with the option to tailor business rules to meet your specific needs. Comprehensive reporting and data analysis capabilities allow for the assessment of staff performance and the identification of educational needs in areas such as Coding, Clinical Documentation Improvement (CDI), Quality, and Providers. Additionally, the SMART Outpatient module boosts claim accuracy and highlights issues related to charge capture and workflow optimization. By mitigating the risks associated with inaccurate coding, it also fosters better regulatory compliance, ultimately benefiting the entire healthcare organization. Furthermore, the integration of these tools significantly streamlines the coding review process, ensuring higher standards of care and operational efficiency.
API Access
Has API
API Access
Has API
Integrations
No details available.
Integrations
No details available.
Pricing Details
No price information available.
Free Trial
Free Version
Pricing Details
No price information available.
Free Trial
Free Version
Deployment
Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook
Deployment
Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook
Customer Support
Business Hours
Live Rep (24/7)
Online Support
Customer Support
Business Hours
Live Rep (24/7)
Online Support
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Vendor Details
Company Name
CoverSelf
Country
United States
Website
www.coverself.com
Vendor Details
Company Name
PwC
Founded
1998
Country
United Kingdom
Website
www.pwc.com/us/en/products/smart.html
Product Features
Product Features
Claims Processing
Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration