Solutions
We use our proprietary technology as the foundation to offer a wide array of solutions that include user-facing products, automation products that run in the background, data as any service (DaaS), data-enhancements, system integrations, and revenue cycle and payment optimization advisory services. Our goal is to meet our clients wherever they need us to be on their revenue cycle journey.
Underpayment Detection System
Opportunity Identification with Machine Learning
The Underpayment Detection System platform is capable of parsing, storing and analyzing every data element on an ANSI standard transaction at a rate of over 3000 physician claims (837P/I or 835) per second. Claim and remittance data is then analyzed against a set of business rules to quickly and automatically identify opportunities to recover at-risk revenue. The Underpayment Detection System also compiles data into customizable outputs sufficient for creating bulk appeals based on the data elements that your payors may request. In addition to finding underpayments, the Underpayment Detection System also tracks total recoveries and percentage of appeals successfully recovered.
Switch provides a risk-free analysis of payment data using the Underpayment Detection System to healthcare providers. We then present you with the opportunities that we believe exist for recovery and allow you decide what to pursue.
Perspectives
Analytics & Business Decision Support Suite
Switch Perspectives is a collection of revenue cycle and financial reporting applications that are available via our web portal 24/7/365 in our HIPAA-compliant cloud. Reports are available on any device, including smart phones and tablets. Process, search and get data on hundreds of data points from millions of records in a matter of seconds.
RateKeeper
Build & Maintenance Automation
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Fee Schedule Builder
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Why take chances on undercharging, when it is the most preventable form of physician billing revenue leakage?
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Our process can build and maintain fee schedules in your billing system, so you never have to worry about another undercharge.
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Contract Builder
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It is more important than ever to have your contract terms built directly into your core billing system. Contract rates help power workflows and provide accurate data for underpayment analysis, patient payment estimates and more.
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Contract Builder ports the contract terms built into the Switch Contract Management System (SCMS) and automatically builds those same terms in your billing system's contract module, through a simple file upload
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Revenue Cycle Compliance Pro
Physician Audit Workflow & Reporting
Rev Cycle Compliance Pro is a full featured audit workflow and reporting application for audit and compliance professionals for physician billing:
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Audits E&M codes for providers in the organization
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Automatically levels E&Ms based on Medicare criteria
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Allows scheduling of groups of providers for future audits
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Performance dashboard on both providers and auditors
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Risk profile allowing comparison of provider against specialty, organization, locally or nationally
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Tracking new provider education
Automation
Automation Suite
Switch develops automated solutions that integrate with your core billing system without the use of bots or end user emulation.
Automations include:
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Secondary balance resolution
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Work prioritization
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Expected reimbursement
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Advanced claim status
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Claim routing
Data Service
Data as any Service
At Switch we understand that the data needs of organizations vary greatly. Many organizations have internal reporting teams and a specific BI tool (Qlik Sense, Tableau, Microsoft BI, etc.) and just need help integrating external data from sources like payers and clearinghouses. Other organizations prefer to have their data available in an out of the box cloud-based analytics tools. And many organizations need data to be transformed and used for industry standard transactions like eligibility (270/271), claim status (276/277), institutional claims (837I), professional claims (837P) and electronic remittance advice (835). We offer data services to fit these services and many more, including highly customized applications and data transformations.
IntegrEDI
EDI Validation
Whether you are testing a new EDI system or a direct submitting EDI transactions to payers, we can provide the assurance that your files are valid. In addition to overall file validity checking, we check for missing required or situationally required data, and also check the validity of values within each data element of an EDI file. Our validation service works on all ASC X12 and all finalized/adopted versions.
While we are primarily focused on providing services to healthcare provider organizations, this product works on any ASC X12 transaction and therefore we offer it as a service to users of these standard transactions regardless of industry.
Engage
Advisory Services
Switch Engage is not a consulting firm in the traditional sense. We do however offer advisory services as an extension of our data products. Switch Engage provides opportunities for our clients to bring us in for targeted project work that is beyond the scope of normal account management that focus on revenue cycle and payment optimization. We use data analytics to create the foundation for evaluating workflows, services offerings, staffing ratios and targets, staff efficiency, staff quality, business operations approach, or business strategies.