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The Full Platform

Purpose-built for reimbursement intelligence

RemitIntel, RCx, HCC, and ClaimStaker — each solving a distinct piece of the revenue cycle puzzle.

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Customer Stories

AdobeStock_489535207Featured Case Study

$475.5K est. annual labor savings

2,500-provider group sees 16% denial reduction

RemitIntel connects 17.5K denials to actionable signals across 1.3M charges.

 

 

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Our Vision

The right care gets paid the right way, the first time.

130K+ providers trust Aptarro to turn reimbursement complexity into a competitive advantage.

About Aptarro
customer success

ACP expands HCC  from 12 sites to 53 with two coders.

Arizona Community Physicians, a leader in value-based care with 53 locations and 166 multi-specialty providers, expanded its HCC coding process across the organization while improving accuracy and reducing the resources required for review.

“The automation Aptarro brought to our HCC coding process led to a dramatic productivity hike in our organization and is a key factor in our success with MSSP.”
Kimberly Clifton, Director of ACO Operations Arizona Community Physicians
the starting point

Scaling HCC review across 53 locations.

Arizona Community Physicians (ACP) is a leader in value-based care. Their Accountable Care Organization (ACO), Abacus Health, was selected to participate in the Medicare Shared Savings Program (MSSP) beginning on January 1, 2016.

During their first two years in the MSSP, ACP deployed a six-step manual process for 12 of their 53 locations to ensure appropriate and accurate HCC codes. Managed by three full-time ACO employees, the process was designed to review all medical records as well as associated claims.

This manual process proved to be inefficient, error-prone, and stressful for coders. Coders were constantly rushing to review claims and medical records for HCC accuracy so claims could be sent to payers. Often incorrect claims were discovered that had already been sent to payers, and coders had to spend additional hours working with the billing team to correct and repost them.

Extending this manual system to cover all 53 locations while maintaining a thorough HCC process would have been even more inefficient and costly. ACP clearly needed a better solution.

The Operating Model

Reducing the time and resources required for HCC review.

With Aptarro HCC Coding Software, ACP was able to automatically review every encounter finalized in the EMR, find encounters with HCC coding gaps and tasks them to coders, and begin concurrent, real-time review of encounters instead of costly retrospective reviews. They were also able to see provider recapture reports, as well as added and deleted HCCs and their effect on RAF value, through reporting.

By automating their pre-claim coding review process, ACP significantly reduced the time and resources required to perform their comprehensive HCC review process, while improving accuracy.

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