# Healthcare

> Sumarity for healthcare: standard workflows with every judgement checked.

Source: https://www.sumarity.ai/industries/healthcare/

Healthcare 

# Healthcare: the doubts, not the drudgery.

Revenue-cycle work: remittances, denials, prior authorisations and coding audits. Many of these judgements can be checked against the payer's own data; the rest reach a person with the record.

Talk to usFilter the library  

What teams tell us

## Where the time goes

Remittances that don't match what was billed

Denials worked one by one

Prior authorisations held up by missing information

Workflows

## Standard workflows for healthcare

7 workflows · Cross-checked: 4 · Proven by code: 2 · Checked by the outcome: 1

### Remittance posting and payer reconciliation (835s)

Which claims a remittance pays; adjustments

Proven by code

### Claim denial management and appeals

Denial reason, appealable, evidence

Checked by the outcome

### Prior authorisation

Criteria met from the record

Cross-checked

### Medical coding audit

Codes supported by the notes

Cross-checked

### Eligibility and benefits verification

Coverage active, benefits apply

Cross-checked

### Provider credentialing

Licences, sanctions, documents current

Cross-checked

### Charge capture reconciliation

Services delivered vs billed

Proven by code  

Questions

## What buyers ask

Which process should we start with?

The one with the most items your team checks by hand and a clear way to tell right from wrong: usually a reconciliation or a matching process. Its judgements are proven by code, so most settle without a person.

Do you connect to our systems?

Files in any layout (spreadsheets, CSV, PDF, bank formats), e-mail inboxes and folders, and an API for software. Connectors for particular systems are built as customers need them.

How long does a pilot take?

A few weeks alongside your own process, on your own data, at our cost. It ends in a line-by-line comparison: what it settled, what it sent to people, what it caught, and the time it took.

## Bring one healthcare process. Run it alongside yours.

We design it with your expert, run it in parallel, and show you the comparison.

Talk to us
