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GE Healthcare, Accenture target $2bn in lost revenue in U.S. healthcare

Staff writer ▼ | May 23, 2016
GE Healthcare and Accenture introduced a new offering to help improve medical claims processing and related cash flow for healthcare providers.
Accenture
Billions lost   DenialsIQ uses powerful algorithms
The alliance, targeting medical claims management, one of the largest areas of lost revenue in the U.S. healthcare system, was announced at GE Healthcare’s annual software users conference in Phoenix, where more than 1,500 users are gathered.

GE Healthcare estimates that, through the combination of analytics and consulting services, these offerings could help healthcare providers to, on average, save between 25-50 percent of their current costs to re-process denied claims.

Part of the GE-Accenture alliance announced in 2013, the offering combines GE Healthcare’s advanced analytics solution, DenialsIQ—which flags claims denials and uncovers potential hidden patterns and root causes therein—with Accenture’s experience and expertise in consulting.

The solution can help providers, including large health systems, physician groups and hospitals, understand how claims management affects their financial performance and then take action to redesign workflows and financial operations based on those insights.

Managing claims denials has proven challenging for healthcare providers. Accenture estimates1 that of the one in every five claims that’s denied, it will cost a typical health system, on average, $25 per claim to re-process.

For a $1 billion health system, reducing claims denials can yield a 0.5-1 percent lift in operating margin amounting to $5- 10 million annually.

DenialsIQ uses powerful algorithms originally designed by GE’s Global Research Center for GE’s Aviation business.

Similar to online shopping software that prompts a user with product recommendations, DenialsIQ can show administrators hidden patterns and root cause factors before medical claims denials negatively impact the revenue cycle.


 

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