Artificial intelligence-powered payer intelligence startup Anomaly Insights announced Thursday a collaboration with Inova Health to improve payment outcomes and support revenue management operations.
Through the partnership, Anomaly will provide Inova with additional data and analytics to evaluate payer behavior and payment outcomes.
“Every dollar we recover through this work is a dollar we can reinvest in the patients and communities we serve,” said Erin Hodson, Inova Health vice president of revenue cycle, in a statement. “By bringing greater visibility and transparency to complex payment processes, we can make more informed decisions and continue strengthening our approach to revenue management."
Executives say the partnership is part of Inova’s broader strategy to bring AI directly into revenue cycle and managed care operations.
Inova identified $10.4 million in recovered revenue opportunities in the first 90 days of the partnership, with an estimated $3.8 million in ongoing monthly revenue impact, according to a Sept. 10 press release.
Anomaly CEO Mike Desjadon told Fierce Healthcare in a statement that watching the teams interact “has been an eye-opening experience.”
“The Inova team is already world-class, but the totality of what they’re up against with insurance companies is genuinely hard to believe until you see the data,” Desjadon said. “Getting to experience first-hand how personally they take their mission of providing world-class care, and how directly they tie every dollar back to supporting patients really connected our team to that same sense of purpose.”
Desjadon said Anomaly is “proud to support Inova’s mission,” adding that “knowing our tools are helping them prevent families from receiving improper denials is deeply rewarding.”
In June, the startup launched a tool aimed at providing managed care executives with evidence to bring to payer negotiations. Anomaly’s Manage offering examines all claims across every payer in a health system’s contract, identifying patterns and synthesizing complex data from contracts to claims.
With the tool, providers can see when each payer denies a claim that should be paid or downcodes services to lower-reimbursement codes.
Numerous health system executives, in earnings calls, surveys and other forums, have said over the past year that they are interested in or are working to adopt tech-based approaches to maximize reimbursements.