Revenue analysis software for intelligent denial management
RevenueQueue automates the tedious task of auditing claim remittances, turning explanation-of-benefits data into business intelligence and discovering missing revenues.

For medical practices, clinics, hospitals, outpatient facilities and other healthcare billing organizations, RevenueQueue reveals reimbursement and denial trends across facilities and across departmental lines.

Revenue analysis
With its unique application design, RevenueQueue presents a logical, high-level overview from which users may “drill down.” RevenueQueue illustrates how denial volumes are trending by any combination of these and other factors:

• Dollar volumes by claim status or claim value
• Percentage of claims denied as compared to claims processed
• Charge and payment analysis by CPT® code
• Denial ranking by:
• Category (eligibility, coding, lacks info, etc.)
• Reason code
• Payer
• Line items

Are eligibility, coding or other issues creating the largest denial volumes? Are specific payers presenting particular problems? Are health plans paying the proper amounts? To answer these and other questions, RevenueQueue can compile the review of millions of claims within seconds.

Denial management
As a collaborative, denial management workflow tool, RevenueQueue helps users prioritize tasks—by payer, volume or dollar value, for example—for greatest impact. Both small and large healthcare organizations can queue specific denials and direct them to appropriate personnel. And the claim volume for any category of denial can be divided among multiple staff members according to payer, patient name grouping, or other options.

Beyond the insurance carriers’ standard denial reason codes, RevenueQueue provides further explanation based on Alpha II’s proprietary, payer-specific knowledge of billing practices. RevenueQueue supplies the claim detail necessary to both resolve individual claims with payers, including relevant internal control numbers and to prevent similar denials from recurring.

The application tracks user productivity and displays the status of all tasks, letting multiple users effectively coordinate their work.

Software developer interface or integration
Whether it’s a quick interface or an in-depth integration, Alpha II works closely with developer partners to ensure efficient, effective and appropriate access to RevenueQueue features. Software developers can interface RevenueQueue’s advanced functionality to their practice management and hospital billing systems with minimal workflow process modifications. For tighter application integration, you can embed the RevenueQueue analysis process to create a work queue displayed within the host application’s user interface.

 

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