Where does avoidable cost actually sit?

Mostly in rework rather than in the care itself: claims that have to be resubmitted, information gathered twice, decisions made without the data and revisited later. That is why cost reduction here is addressed as a workflow and information problem rather than as a procurement one.

How do payers and providers both benefit?

Because they are handling the same transaction. Payers are helped to control medical costs and to partner with providers for improved outcomes; providers are helped with revenue enhancement, cost control and payment accuracy. An improvement that only helps one side tends to get negotiated away.

What does information sharing have to do with cost?

A great deal. Sharing information enables care coordination, risk analysis and care network management — and each of those prevents spend that would otherwise be incurred and then disputed. Withheld information is usually paid for twice.

Is this about spending less or earning more?

Both, and separating them misstates the problem. Optimising profit performance means improving payment accuracy as much as reducing outlay — a claim underpaid because it was coded imprecisely is a cost, even though it appears nowhere in a cost report.

What should we measure?

First-pass acceptance, days in accounts receivable, and cost per episode. Those three cover the ground between them, and all three move for reasons you can trace — unlike headline spend, which moves for reasons you usually cannot.

Bring Down Costs

Patient Journey

At every single stage of a patient's journey, Nano Health is encouraging an enhanced healthcare system with pioneering financial, clinical, and engagement solutions to enhance the customer experience, operational efficiency, regulatory compliance, and patient outcomes.

We enable the payers to create the information-sharing phenomenon for foremost health care coordination, risk analysis, as well as care network management.

We furnish backings to our clients with better decision support and clinical reviews. Nano Health administers insurance payers in controlling their medical costs and teams up with the providers for improved outcomes.

Revenue Management

Nano Health assists in revenue enhancement and cost control for its payers and providers. It optimizes the profit performance, increases payment accurateness, facilitates the value-based payment and care processes, enhances the claims management, helps patient cost estimation, and improves the charge capture precision.

Furthermore, we also provide support to consumer payments and develop coding and amenability. If you desire to streamline the payment collection and billing process, smoothly escalate the cash flow, or cut short the administrative costs, at Nano Health, we provide our customers and clients with software-based services that benefit the payers and providers with payment accuracy, revenue cycle management, revenue integrity, value-based payments and analytical solutions, pharmacy benefit solutions and more.

Redefining the payment solutions

We support our clients to productively navigate the shift from paid services to value-based reimbursement. We assist our customers who are new to value-based reimbursement to recognize and invest in such payment initiatives, leveraging our Insurance management solutions and claim-Engine regulator platform.

With stress-free Nano health payment solutions, patients can accurately comprehend and analyze their out-of-pocket costs afore receiving care. The cost transparency assists the patients to manage their expenses, enhancing their satisfaction, and acting following the governmental regulations.

Leaders of the healthcare and insurance industry are transitioning to unconventional payment models that solely focus on value-based payment processes. Nano health settles its payers to succeed in constructing a provider-payer alliance essential to aid current prototypes.

Timely Payment

Claim-Engine

Transparency
Assists

Cost
Management

Better Financial
Outcomes

Care Data & Analytics

We make use of machine learning (ML) and artificial intelligence (AI) analytics to assess the best value-based model addressing the cost variations and quality within the particular provider and market base.

Our healthcare solutions help the providers to establish an early strength in revenue cycle operations. Our solutions ensure patients' financial transparency.

Revenue Cycle Management

We help our providers to shore up the central revenue cycle process to capitalize on revenue with a pliable blend of prominently superior technologies and the influence of professional and skillful individuals.

Nano Health lowers the cost-to-collect and bad debt risk by amassing more payments before, during, and after service, as well as by decreasing third-party collections. Analytics solutions at Nano Health help to analyze problems, benchmark the performance with specialists, and prioritize the prospects that greatly impact financial and monetary outcomes, staff productivity, as well as patient outcomes.

Our solutions enable payers and providers to handle the complex tracking and payment
processes to sustain both the prospective and retrospective payment models.

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How this works with the rest of the suite

NANO RCM
Most avoidable provider cost is rework in the revenue cycle, which is the single largest lever on this page.
NANO CSS
A rejected claim costs more than one that was never wrong, so the scrubber is prevention rather than recovery.
NANO PLICS
You cannot reduce a cost you cannot attribute, which is what patient-level costing makes possible.
NANO FWA
On the payer side the equivalent lever is paying only what should be paid, before the money leaves.

Frequently asked questions

Where does avoidable cost actually sit?: Mostly in rework rather than in the care itself: claims that have to be resubmitted, information gathered twice, decisions made without the data and revisited later. That is why cost reduction here is addressed as a workflow and information problem rather than as a procurement one.
How do payers and providers both benefit?: Because they are handling the same transaction. Payers are helped to control medical costs and to partner with providers for improved outcomes; providers are helped with revenue enhancement, cost control and payment accuracy. An improvement that only helps one side tends to get negotiated away.
What does information sharing have to do with cost?: A great deal. Sharing information enables care coordination, risk analysis and care network management — and each of those prevents spend that would otherwise be incurred and then disputed. Withheld information is usually paid for twice.
Is this about spending less or earning more?: Both, and separating them misstates the problem. Optimising profit performance means improving payment accuracy as much as reducing outlay — a claim underpaid because it was coded imprecisely is a cost, even though it appears nowhere in a cost report.
What should we measure?: First-pass acceptance, days in accounts receivable, and cost per episode. Those three cover the ground between them, and all three move for reasons you can trace — unlike headline spend, which moves for reasons you usually cannot.