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How the 15-Minute IBill Review Works – Explained

Our 15-Minute IBill Audit is an end-to-end solution that allows healthcare Payers of any size, shape, or scope to produce quality itemized bill reviews in under 15 minutes. We're maximizing automation with intelligent software and technology that learns and adapts to specific program needs. See first-hand, how the workflow is optimized at every step to minimize provider abrasion, accept customizations, and evolve at the speeds of the healthcare industry.

The market-first end-to-end review ecosystem empowers analysts to finalize reviews in under 15 minutes without compromise in accuracy or consistency of results. We offer our payment integrity platform as SaaS, full-services or, Hybrid to yield maximum savings and recoveries and complete more reviews in less time for the fastest speed to pay.

The 15-minute hospital itemized bill review transforms the healthcare landscape for a truly proactive approach to payment integrity and has a ripple effect across the entire healthcare ecosystem. Under ClaimLogiq innovations, facility claim reviews are completed at the fastest speed to pay for near real-time outcomes and the closest to auto-adjudication.

So, what does the system workflow look like, and how does it produce these lightning speed results in any mode of implementation while maintaining ClaimLogiq's hallmark accuracy and consistency?

Discover how it's possible to maintain transparency into the claim review process, control over, and real-time insight into your claim workflows, optimized by customizations that suit every payer and provider agreement. Let's break down the technology and software stack that ClaimLogiq has developed to align with every Payer's payment integrity needs, transforming payment timelines.

15-Minute IBill Audit Workflow

1. CORRE

CORRE, ClaimLogiq's Operational Routing and Rules Engine, is data agnostic and scans the claim file data, matching it against the payer’s custom and industry-standard rules. It executes additional rules based on a Payer-personalized selection library to maximize savings. Then, it makes the final determination on each claim to be paid or pended for review and instantly routes it to the appropriate party—all in under 250 milliseconds.

 

Within a quarter of a second, CORRE has already performed pay or pend decisions for each claim uploaded to our secure framework. All pay decisions will be immediately sent back to the payer handling, and any pended claims are routed immediately to ROCR for IBill upload and data normalization.

 

2. ROCR

ClaimLogiq's intelligent data capture system, ROCR (pronounced rocker) – or Rapid Optical Character Recognition tool cleanses and refines virtually limitless volumes of inconsistent claim data layouts from disparate sources for easy access and reference. Its multi-threaded capability performs intelligent OCR of multiple IBills at once, in minutes, even seconds. ROCR combs through millions of data points in seconds to produce reliable, quality outputs in machine-readable text, instantly available for final review in the beautiful UI of TrueCost.

 

ROCR is an agile and adaptive technology that is constantly refined for continued quality output.  ROCR is also data-agnostic, capable of reading multiple data types and at lower qualities for clear and accurate IBill data. This reduces the number of requests and minimizes provider abrasion.

 

ROCR reduces the number of human touchpoints needed and increases automation. This leads to fewer errors and faster speeds.  And because of the learning framework of the technology, it adapts to learned formats and customized rules for each itemized bill, continuing to reduce the amount of time large and complex files spend in ClaimLogiq's OCR.

 

3. TrueCost

ClaimLogiq's all-in-one cloud-based platform is available as SaaS, full-services, or Hybrid of the two, adapting to the unique needs of every Payer's payment integrity program needs. Once the data is normalized in ROCR, the IBill is instantly ported into TrueCost and automatically routed to the right team member for review.  TrueCost presents claims ready for review for Payer’s in-house teams or ClaimLogiq experts, without ever leaving the all-in-one platform. The software closes the gap in the payment cycle for near real-time payment on all large/complex claims – with no compromise in our hallmark accuracy and consistency. Large IBills are available for easy read and reference within TrueCost as the enhanced user experience empowers analysts to finalize reviews in just a few minutes for maximum savings or recovery.

ROCR.15MinuteIBillAudit.Workflow

The 15-Minute IBill Review  - Changes the Landscape of Payment

Integrity

The proprietary technology and software are poised for replication throughout all facility claim reviews.  Its design is adaptable across the entire spectrum of healthcare payment integrity for faster, more accurate reviews. You can see real examples of the 15-Minute IBill Audit in action by downloading our case study.

And, better yet, ClaimLogiq’s 15-Minute IBill review solution doesn’t come at a quality opportunity cost. This end-to-end review ecosystem maintains the company’s industry-leading standards of <5% appeal rate and <1% overturn rate. 

Payers unable to complete thorough reviews of complex claims in preferred TATs can now confidently utilize ClaimLogiq's end-to-end solution to bring payment integrity programs in-house.  Not only is it possible to use the SaaS platform to bring reviews in-house, but also move from retrospective to prospective reviews, avoiding costly penalties and late fees associated with typically long review and payment timelines.


Every day, we're working towards our vision of challenging an industry dominated by rising costs and inconsistent outcomes to utilize innovative solutions in overcoming barriers that perpetuate healthcare stagnancy.

Read about how the 15-Minute IBill Audit is transforming the entire payment integrity ecosystem in our article below.

Read the Article

Rebecca L. Price
Rebecca L. Price
As the Vice President of Brand Marketing and Communications, Rebecca leads the strategy for ClaimLogiq communications and engages with ClaimLogiq's audience through social media and other digital platforms. Rebecca has decades of experience writing about software and technology and has produced informative healthcare innovation materials in the form of white papers, print, and video content. Rebecca studied Integrated Strategic Communications and holds a bachelor’s degree from the University of Kentucky.

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How the 15-Minute IBill Audit Transforms the Payment Integrity Landscape

While the typical hospital claim review can take days to weeks – ClaimLogiq’s solutions empower analysts to finalize reviews in hours, even minutes. Now, ClaimLogiq has announced the 15-Minute IBill audit as part of our regular claim lifecycle audits.  The breakthrough 15-Minute IBill Audit is game-changing for payers of all shapes and sizes. Now, lengthy audits for complex hospital itemized bills, and unavoidable overpayments and recovery efforts, are a thing of the past.

How the 15-Minute IBill Review Works – Explained

Our 15-Minute IBill Audit is an end-to-end solution that allows healthcare Payers of any size, shape, or scope to produce quality itemized bill reviews in under 15 minutes. We're maximizing automation with intelligent software and technology that learns and adapts to specific program needs. See first-hand, how the workflow is optimized at every step to minimize provider abrasion, accept customizations, and evolve at the speeds of the healthcare industry.

How to Successfully Implement your Payment Integrity Program in Under 90 Days

All payment integrity programs are not created equal. The process for implementing a payment integrity program will look different for every healthcare plan -- and for good reasons. However, it is possible to successfully implement these differing payment integrity programs in under 90 days with the right business partnership and aggressive (yet very achievable) tactics and strategies. 90 days might seem ambitious, but, when payers work with a partner that is capable of bridging any gaps in the implementation process, it is possible to achieve swift implementation timelines. When we approach all client relationships as true business partnerships, it benefits all areas of every program execution. Our operational execution is second to none, our team is stacked with experts with decades of experience in the payment integrity space, and our TrueCost solution offers transparency, client-driven control, customizability and flexiblity to meet every need. These factors are what sets ClaimLogiq apart -- not just during the implementation phase -- so we're ready to move as fast as our clients can when it comes to crossing major milestones of any program implementation.