By leveraging our proprietary Dragonfly platform, Utilize for Providers enables users and clinical leaders to go beyond the boxes and ensure appropriate level of care for every patient, while automating and streamlining decision-making within utilization review, case management and revenue cycle activities — all on one platform.
With access to a real-time view of their patient census, prioritized by risk, Dragonfly Utilize enables teams to focus on the cases that need their attention without wasting time manually reviewing-driving clinical efficiencies without adding increased administrative tasks. Dragonfly Utilize’s AI-driven medical necessity score, the Care Level Score™ (CLS™), synthesizes relevant clinical & financial data from the EMR to identify and prioritize patients in real-time.
With a remarkable track record of over 2 billion predictions and counting, care teams and their leaders can confidently rely on the CLS, presented for each patient in a work queue, to predict inpatient or observation status with up to 94% accuracy. Leveraging this data allows your teams to offer consistent care and ensure every decision is truly objective.
Help your clinical and revenue cycle teams as well as connected payers do more through an objective, data-driven view of medical necessity focused on “getting it right” that creates efficiencies and improves patient status accuracy from bedside to final payment.
Dragonfly Utilize strategically aligns utilization review and revenue cycle teams with their payer partners to reduce the need for wasteful retrospective audits and reviews and significantly reduce the cost of care. Standardizing and automating much of the process, Dragonfly Utilize improves payer relationships, reduces friction, and helps to mitigate medical necessity denials. Dragonfly works to improve patient care by getting them in the right status, at the right time, with the right reimbursement.
Providers and payers collaborate and engage on a common platform, allowing for a real-time, standardized view of the patient’s medical necessity that can enable automated Level of Care determinations using the Care Level Score™. This proprietary analytic is a numerical representation of severity of illness, intensity of service, and the overall clinical merit of the case. As the CLS increases, the alignment with appropriate status also increases. As a result, hospitals spend less time in the UM/UR and revenue cycle processes with payer partners, which enhances collaboration and relationships.
Alerts from Xsolis’s platform helped Hillcrest Healthcare catch over $420k in potentially missed IP revenue.
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Dragonfly Utilize can help your organization yield better results through smart payer-provider collaboration.