{"id":18517,"date":"2021-10-11T00:00:00","date_gmt":"2021-10-11T04:00:00","guid":{"rendered":"https:\/\/www.sisense.com\/success\/efficientc\/"},"modified":"2024-08-15T17:08:05","modified_gmt":"2024-08-15T21:08:05","slug":"efficientc","status":"publish","type":"case-study","link":"https:\/\/www.sisense.com\/success\/efficientc\/","title":{"rendered":"Healthcare claims processor achieves 95% success rate for customers with Sisense analytics"},"content":{"rendered":"

Meet efficientC<\/h2>\n

Unpaid claims payments are one of the biggest causes of revenue loss for hospitals and healthcare providers. To help reduce errors when processing claims, healthcare providers use claims scrubbers (data checking software) to ensure that claims that leave the door have the best chance of getting paid, ideally the first time they are submitted. In 2009, Lori Zindl, the CEO and founder of the claims processing company OS Healthcare, developed efficientC, a software platform with denial prevention technology that accelerates revenue generation for hospitals. efficientC combines the capabilities of a clearinghouse and claims scrubber with the power of analytics, enabling hospitals and healthcare providers to get their claims paid by insurers faster, with fewer claim denials.\u00a0\u00a0<\/p>\n

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efficientC\u2019s challenge: Improve ease of use and optimize performance to increase customer adoption of analytics\u00a0<\/h2>\n

The medical billing process in the United States is particularly challenging. If a claim is denied by insurance the first time, it has a 60% chance of being denied a second time and an increased chance that it will never get paid. The cost of reworking a claim can average as much as $118 per claim, according to Becker\u2019s Hospital Review, leading to reduced profitability.\u00a0\u00a0<\/p>\n

Before switching to Sisense, efficientC used a different embedded analytics solution, but \u201cfound that it was inefficient and wouldn\u2019t scale. It was a challenge to get our customers to adopt and use the dashboards.\u201d says Lori Zindl. They wanted a solution that would make it easy for both external and internal end-users to get their insights faster, be quick to implement with fewer staff, and scale over time.<\/p>\n

efficientC\u2019s immediate and ambitious goal is to help its customers increase their First Pass Yield Rate (percentage of claims paid at first submission) from an industry average of 75-80% to upwards of 90-95%.\u00a0<\/p>\n

Using Sisense to achieve customer experience excellence<\/h2>\n

\u201cWith Sisense, we immediately were able to give life to a whole lot of powerful use cases and options that were conceived by our customers and our founder Lori,\u201d says Michael Schram, Director of Product Development & Strategy at efficientC. The company presents healthcare providers a complete and comprehensive view of crucial KPIs using their Sisense-powered analytics tool, Insights<\/em>. Customers now have rich, interactive dashboards to explore data and track payment trends in the revenue cycle, and flag them if they\u2019re falling behind.<\/p>\n

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Sisense also provides efficientC with the agility and flexibility to rapidly tackle multiple challenges to scale. For example, it would typically take 20 minutes to manually run a report based on 6-months data for a customer. Now the same report, which is also automated, takes 5-10 seconds per load, and even less time with smaller datasets. With reduced time to insight, customers have the ability to achieve more with less. One hospital customer reduced claims denials by nearly 40% within six months of adoption.<\/p>\n

Further, with intuitive and easy to use dashboards, usage and adoption skyrocketed. \u201cOur dashboards are now used every day by most end-users,\u201d reports Lori. Adds Michael, \u201cThe simplicity with which we can move and the speed with which we can move is great. And now we can offer that to our customers as part of our value proposition.\u201d\u00a0\u00a0\u00a0\u00a0<\/p>\n

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Going for Gold\u00a0<\/h2>\n

Following its culture of innovation, Sisense has helped efficientC successfully differentiate its product from the competition. Michael uses the analogy of an Olympic figure skater to explain their approach in an emerging healthcare\/billing technology space crowded with similar offerings. \u201cIt isn\u2019t enough to be the most technically gifted figure skater. You have to pull in all the technical elements with speed, fluidity and flair to win the gold,\u201d he says. \u201cSo as a clearinghouse, you could have all those technical capabilities like the rest of the competition, but the key to success is to integrate it for the customer seamlessly and with a great presentation.\u201d<\/p>\n

The results speak to the success of efficientC\u2019s approach and strategy: 95% of customers\u2019 claims get paid within 20 days or less, an average 15% cash flow improvement for customers, a 40% reduction of denials in 60 days of implementation, and increased cash collections with decreased write offs.\u00a0<\/p>\n

efficientC is also ready for the next stage of its business evolution \u2014 becoming an analytics-driven company, enabling cash flow predictions for customers with Sisense\u2019s AI-driven forecasting capabilities.\u00a0 <\/cite><\/p>\n","protected":false},"excerpt":{"rendered":"

Healthcare claims processor achieves 95% success rate for customers with Sisense analytics<\/p>\n","protected":false},"author":4,"featured_media":18519,"template":"","meta":{"_acf_changed":false,"_searchwp_excluded":"","footnotes":"","_links_to":"","_links_to_target":""},"application":[46,26],"asset-category":[],"department":[22],"industry":[11],"role":[],"team":[],"topic":[],"class_list":["post-18517","case-study","type-case-study","status-publish","has-post-thumbnail","hentry","application-bi-analytics-teams","application-product-teams","department-executive","industry-healthcare"],"acf":[],"yoast_head":"\nefficientC Case Study | Sisense<\/title>\n<meta name=\"description\" content=\"Healthcare claims processor achieves 95% success rate for customers with Sisense analytics\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.sisense.com\/success\/efficientc\/\" 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