Introducing the InSight Revenue Cycle Solution™ software suite, designed by the experts at ClaimTrust to target the key inflection points in the revenue cycle to ensure that hospitals efficiently collect all of the revenue to which they are entitled. This is the first hospital revenue cycle system to offer comprehensive all-payor edits down to the fiscal intermediary (FI) and plan level as well as the ability to deduce unbilled charges and generate net new revenue—the result is a powerful suite designed to find hospitals more cash than any other solution available today.

The InSight Revenue Cycle Solution includes these products:

InSight Medical Necessity™

Validates medical necessity on the front-end of the revenue cycle. InSight Medical Necessity checks HCPCS, CPT, and ICD-9 codes for medical necessity, provides access to LCDs and NCDs, and generates both general and lab ABNs and statutorily non-covered forms.

InSight Compliance™

Automatically identifies claim errors prior to submission. InSight Compliance processes claims against the ClaimTrust library of payor edits and rules and provides analyses and reports on claims data.

InSight Workflow & Claim Editor™

Provides workflow routing and real-time repair of any claims flagged by our library of payor edits and rules. Claims are routed to the appropriate user and presented in a virtual UB-04 interface so they can be repaired and submitted to the payor in the correct format.

InSight Payment Variance Analyzer™

Identifies, tracks and helps eliminate revenue lost in the form of underpaid claims.

InSight Denials™

Drills into 835 remittance data to uncover the root causes leading to denials. InSight Denials analyzes, tracks, trends and reports on denial data and provides workflow tools to distribute denied claims to the right departments and individual team members for resubmission.

InSight Audit™

A powerful and easy-to-use application designed specifically to address the data-entry, tracking and workflow challenges that RAC Audits, Medicaid Audits, and other payor audits present to the hospital organization. InSight Audit is a comprehensive, web-based audit management tool that manages all of your medical claims audits and workflows from one central location.