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Alphalytics in Action

Charge Master Mapping

Lumedic Alphalytics is a team of experts who are committed to leveraging advanced technology in concert with our Agile product development strategy to provide you strategic and impactful insights into your first-pass performance on submitted claims. Utilizing machine-based learning technology, we uncover the hidden data patterns behind your initial denial and underpayment rates.

ISSUE

Charge Master Mapping

An Alphalytics profile identified that for two years Medicare had been initially denying 100% of cochlear implants CPT 92604 for utilizing an incorrect revenue code.

SOLUTION

Identification and Correction

After researching the accounts identified by Alphalytics, the health system determined their charge master was mapping CPT 92604 to the wrong revenue code. Once the charge master was corrected, the issues was resolved.

CONCLUSION

*Revenue Cycle Process Improvement*

Utilizing Alphalytics to Identify non-obvious issues positively impacted this client's entire revenue cycle process.

Even with 100% denial rate this issue was not recognized prior to Alphalytics because the current manual process was overturning the denials. Unfortunately, while payment was received, the client's effective reimbursement was dramatically reduced after applying their manual cost to collect calculation.

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