Comprehensive Bill Review & Business Intelligence Solution
Detect and make better decisions on bill level and claim level treatment exceptions
Mitchell SmartAdvisorTM Embedded Analytics provides a solution for detecting bill level and claim level treatment exceptions so your staff can make smarter decisions that improve outcomes. SmartAdvisor Rarity Edits and Relatedness Edits are analytics technologies that identify uncommon or non-compensable treatment. With Embedded Analytics, you get to see an automated review of treatment or services that do not have—or require—utilization review decisions.
- Rarity Edits identify potentially inappropriate billing practices by flagging bills that have procedure and diagnosis codes that are rare in the industry.
- Relatedness Edits identify outlier claim exceptions based on claim injury information and diagnosis codes, and flags them so bills can be manually reviewed.