Oncology Convergence Incorporated (OCI)
Oncology Convergence Analyzes Reimbursement In Order to Enhance Revenue
Oncology Convergence (OCI) works with oncology based practices across the nation, with the goal of helping them enhance their revenues and reduce their overhead costs. Their customer base includes dozens of medical oncology, radiation oncology, pediatric oncology and GYN oncology practices. Some are office based, others hospital based, and some are integrated cancer centers. They range in size from solo practitioners to large multi-specialty hospitals.
OCI's work is data intensive, and leverages data from multiple sources and systems. OCI team members explore their clients' data in ad hoc manners to discover patterns and trends, and identify outliers. They need to be able to move quickly from high level patterns in summary views of the data, all the way down to individual charges for each patient in order to take action. The summary provides the high level view, but the detail is critical for taking action.
Traditional reporting and scorecard tools have not provided the flexibility and ease of use necessary for OCI business analysts to dig into the data. So, a year and a half ago they added in-memory interactive visualization tools from MedAdvizor. Up until that time the analysts were reliant on IT staff with strong database skills to cut the data and prepare it in the right way for analysis. Unfortunately OCI's best analysts had extensive experience in healthcare administration and oncology based practice operations, not database queries!
This new data discovery and analysis capability has allowed OCI to launch a program called Radiation Revenue Recovery™, and a second one called Infusion Revenue Recovery™. These programs identify:
- Changing reimbursement rates
- Unbilled procedures
- Incorrectly billed unit amounts
Once these items are identified, OCI's experienced staff assists its clients in re-billing the appropriate charges back to the patient's insurance plan. The resulting return has been substantial: (1) more revenue, (2) reduced clinical staff time used for chart audits, (3) reduced administrative staff time used chasing down insurance claims, and (4) reduced bad debt.
OCI is now working on a new initiative in partnership with ADVIZOR Solutions - Oncology ADVIZOR - to implement both financial and clinical analysis data discovery solutions at their clients' sites. The goal is empowerment, providing clients the tools so that they can ultimately manage and optimize their revenue and cost flows on their own. OCI believes that the new interactive visualization products are simple enough to use that client practitioners can now explore their data on their own, and make ongoing decisions for revenue recovery and cost containment without outside help.