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What is PwC SMART?

PwC's Systematic Monitoring and Review Technology (SMART) significantly improves the efficiency and effectiveness of assessing the quality of both inpatient and outpatient coding processes while creating a robust framework for quality assurance and compliance evaluations. Supported by PwC Health Information Advisory, SMART strengthens your approach to monitoring coding accuracy and enhancing overall data quality. The inpatient module of SMART includes more than 1,000 predefined business rules aimed at identifying possible coding mistakes and opportunities for improving documentation, with flexibility to customize rules according to specific organizational needs. Its extensive reporting and data analysis features facilitate the evaluation of staff performance and highlight areas that require educational focus, such as Coding, Clinical Documentation Improvement (CDI), Quality, and Providers. Moreover, the outpatient module enhances claim accuracy and brings attention to issues concerning charge capture and the optimization of workflow processes. By addressing the risks associated with inaccurate coding, the system also promotes better regulatory compliance, ultimately leading to advantages for the entire healthcare organization. Furthermore, the combination of these modules effectively simplifies the coding review process, thereby ensuring elevated standards of care and improved operational efficiency, which can significantly impact the overall success of healthcare delivery. In this way, organizations can not only enhance their coding practices but also contribute to a higher quality of patient care.

What is CoverSelf?

CoverSelf has introduced a cutting-edge, cloud-based platform designed to enhance claims accuracy in the healthcare industry, employing the latest in software development techniques. This state-of-the-art solution empowers users to achieve long-term success by effectively adapting to ongoing shifts in claims and payment inaccuracies, which helps reduce obstacles and administrative costs. By facilitating open collaboration among all stakeholders dedicated to addressing claims inconsistencies and operational inefficiencies, the platform promotes quicker customization, innovation, and deployment. Additionally, CoverSelf’s payment integrity system harnesses modern technologies to address payment leaks and inaccuracies, all while ensuring a high degree of transparency and accessibility for payers. The platform encourages the development of new scenarios and data mining algorithms, thus fueling product innovation and expediting customization processes within a specialized framework that boosts the pace of innovation. Furthermore, it automates claim correction and processing, removing the need for additional human input, which leads to even greater operational efficiency. This holistic approach not only streamlines the claims process but also plays a crucial role in enhancing overall healthcare operations and outcomes. Ultimately, by integrating these advanced features, CoverSelf positions itself as a leader in transforming claims management within the healthcare sector.

Media

Media

Integrations Supported

Additional information not provided

Integrations Supported

Additional information not provided

API Availability

API Availability

Has API

Pricing Information

Pricing not provided

Pricing Information

Pricing not provided

Supported Platforms

SaaS

Supported Platforms

SaaS
On-Prem

Customer Service / Support

Standard Support
Web-Based Support

Customer Service / Support

Standard Support
Web-Based Support

Training Options

Documentation Hub
Online Training
On-Site Training

Training Options

Documentation Hub
Online Training
On-Site Training

Company Facts

Organization Name

PwC

Date Founded

1998

Company Location

United Kingdom

Company Website

www.pwc.com/us/en/products/smart.html

Company Facts

Organization Name

CoverSelf

Company Location

United States

Company Website

www.coverself.com

Categories and Features

Claims Processing

Not specified

Categories and Features

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