SMART Inpatient includes 1,000+ pre-defined business rules that identify potential coding inaccuracies and documentation improvement opportunities. You can also customize business rules for your specific areas of focus. Reporting and data analysis help you evaluate your staff’s performance and pinpoint education opportunities for Coding, Clinical Documentation Improvement (CDI), Quality and Providers.
SMART Outpatient improves the accuracy of claims and identifies charge capture issues and areas for workflow improvements. It also improves regulatory compliance by decreasing the risks caused by inaccurate coding across all ambulatory services and selected areas, such as emergency departments or observation patients.
SMART Professional, coming later this year, will leverage the proven success of our coding accuracy workflow to analyze 100% of claims for all medical specialties and services. Coding and billing related edits will be designed to both improve coding and charge capture and reduce compliance risk. Custom reports will give management insight on areas to focus physician education, outliers compared to peer benchmarks and E&M profiling.
Unique flexibility to reconfigure processes, edits, and settings.
End-to-end outsourced solution that provides the people, processes, and technology required for defensible, cost-effective eDiscovery.
Skip the in-house headaches with our small, highly skilled, and nimble workforce with deep investigative mindsets empowered by best-in-class technology.
Alerts your staff when there are potential coding errors or opportunities which gets your billing out the door quicker.
Multiple updates to include revised filters and new proprietary flags targeted to reduce the risk of errors stemming from new coding rules and standards.
Automates the review process so your staff can cover more cases and simplifies the coding evaluation process, allowing for more efficient use of scarce or costly coding auditor resources.
“PwC's SMART (Systematic Monitoring and Review Technology) supports client coding quality monitoring to increase the efficiency and effectiveness of coding and enable quality and compliance reviews. In one client case study, SMART drove an impact of $1.8 million as a result of about 17% of flagged cases reviewed needing corrections and a diagnosis-related group (DRG) revision in over half of the cases flagged.”
IDC Research, Next-Generation Revenue Cycle, May 2020
“PwC brings a sophisticated approach to customer insights on a leading platform. PwC aims to be a one-stop shop for healthcare analytics and professional services.”
The Forrester Wave™ Healthcare Analytics, Q4 2018
With 25+ years in the market, SMART is built on decades of coding and billing process work resulting in the most extensive business rules in the market. Talk to our team about what SMART can do for you.
“It’s difficult for our clients to review thousands of claims before they bill. SMART flags help them to pinpoint which cases need a second look and reduce time wasted on those with no errors.”
“SMART really shines when you bring in new coding staff because it can closely monitor their accuracy and identify areas of concern so that training can be provided quickly.”
“You have to be ready to respond in a timely manner. But I think a better way to prepare yourself is to determine how to stop denials from happening in the future. That is where SMART comes in to maximize accuracy and reduce rework.”