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Payer Performance Enhancements
Payer Performance Enhancements

Improvements to our Payer Performance recovered amount calculations

Updated over a week ago

We're excited to announce significant improvements to our Payer Performance recovered amount calculations, aimed at enhancing accuracy and reliability. These enhancements address various bugs and logical errors, ensuring a smoother and more precise experience. Additionally, as part of our commitment to continuous improvement, we've bolstered these changes with comprehensive testing and safeguards to prevent any regression of this logic. Future enhancements to recovered amount calculations will build upon these improvements, maintaining the integrity and accuracy of your billing data.

1. Controlled Recovered Amounts

Recovered amounts will now align with the original detected payment variance, ensuring financial insights are more reliable and never exceed the expected figures.

2. Zero-Denial Clarification

In instances where the expected amount is $0 (due to claim denial), the recovered amount will accurately reflect this, removing any confusion regarding denied claims.

3. Accurate Multi-Line Reimbursements

We've improved our system to correctly process claims involving claim-level reimbursements and multi-line reimbursements, offering correctness across varied billing scenarios.

4. Resolution of Calculation Errors

Previously encountered calculation errors, where recovered amounts were incorrectly shown as $0, have been corrected to ensure all valid reimbursements are appropriately acknowledged.

5. Prevention of Overbilling

We've addressed issues where recovered amounts exceeded billed charges, eliminating discrepancies in billing figures.

6. Elimination of Double Counting

Double counting in recovered amounts has been resolved, ensuring the accuracy and consistency of your financial reports.

As we roll out these changes, you may notice some fluctuations in your reported recovered amounts. Rest assured, these fluctuations signify the system's adjustment to the enhanced calculation methodology and reflect an overall increase in accuracy. We're confident that these enhancements will streamline your Payer Performance processes and provide you with more reliable financial insights.

Should you have any questions or require further assistance, please feel free to reach out via chat or email at support@rivethealth.com.

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