PayerWatch Veracity is a state-of-the-art SaaS solution and enterprise revenue protection engine designed specifically for hospitals and health systems to regain control of their revenue cycle by streamlining claim denial and commercial insurance company audit management.
The platform functions as a comprehensive, interdepartmental workflow engine that drives performance improvements in denial prevention, DRG downgrade overturns, peer-to-peer intervention, and complex medical appeals.
Key Capabilities and Benefits:
- Root Cause Analysis: Veracity identifies the root causes of denials by capturing coding and clinical validation changes, allowing organizations to implement targeted strategies for revenue cycle improvement and prevent future denials.
- AI-Assisted Appeals: The platform delivers first draft appeals in minutes with a high accuracy rate (96% on Emergency Department Level-of-Care downgrades), which includes human-in-the-loop verification prior to submission.
- Comprehensive Workflow: It offers end-to-end workflow management, documentation, and delivery tools for all denial, audit, and appeal processes.
- Detailed Analytics & Reporting: Teams get detailed analytics and data visualization through customizable dashboards. Features include automated report scheduling, drill-down reports to identify trends (e.g., by payer, physician, department), Codes Review Reporting, and Won/Lost Reporting.
- EMR-Agnostic Integration: Veracity is EMR-agnostic, working seamlessly with major systems like Epic, Oracle Health (Cerner), and MEDITECH via current workqueues, attachments, secure feeds, and APIs.
Veracity is proven in over 500 hospitals nationwide and is a robust solution for minimizing data errors, promoting best practices, and keeping denial management strategies updated with the latest regulatory shifts and payer policies.
