Organizations today face the same type of challenge that they have had over the last two decades – streamlining processes, getting the maximum dollar for the rendered services, and cutting through complex payer contracts and adjudication processes.
However now, it is a lot tougher on three counts – increasing operational and compliance costs, less helpful payer processes, and the demand for a fully digital RCM experience. Quintessence has left no stone unturned by creating simple, easy to deploy, and intuitive technology to counter the massive budgets of payers on one side and managing physician workflows on the other. Not to mention their proprietary platforms that power productivity to focus on outcomes at high and sustained levels of quality.
Smart Technology Wrapped Around Existing Systems
Quintessence is developing, customizing, and deploying smart technologies that wrap around a customer’s practice management systems and EMR. This is a unique value proposition offered by Quintessence that is usually missing with the competitors.
They have built tools, platforms, and BOTs for every function of the Rev Cycle for each one of their customers – this helps raise staff productivity, ease workflow friction, enhance automation and assure high levels of sustained quality outcomes.
Their products integrate with customer systems either through APIs or data exchange involving HL7 or other formats. The company has built bi-directional exchanges with several of its customer EMRs and PMSs. These tools can be deployed within customer networks or hosted in the cloud or data centers in the US.
Driving AR Resolution Through Intelligence
Quintessence’s smart solutions combined with analytics, insights, and intelligence push claims towards resolutions and seamlessly deliver the reimbursements that are due.
For example, let’s take their AR process. Reimburssence, their proprietary AR intelligence engine, pulls claims daily that need to be addressed. With a daily pull routine, a lot of wasted effort is avoided.
Dynamic auto-allocation algorithms allow for sharp responses to changing requirements. By grouping and ordering claims, it ekes efficiency at every step of the way. The assist engine guides staff through the path of best outcomes so claims can be pushed to closure rather than just being touched and left to age out.
“We measure by touches to closure and touches per type and generate analytics that can further attune allocation and assist library. Finally, notes so captured can be input into your PMS that can feed your native dashboard or we can build a custom dashboard that will meet your business needs,” says Nirmal Kumar Rajachandran, CEO & Co-founder of Quintessence.
Using Reimburssence has resulted in a predictable and transparent AR process – the most challenging part of the Rev Cycle.
Reimburssence: An AR Buster Engine
Reimburssence can work with every PMS system. Further, it zeros in on the area where every company has been facing challenges – how do RCM and provider markets go toe to toe with payer technologies several times the budget.
Reimburssence is an intuitive AR buster engine created by expert billing staff. Simple to deploy and easy to configure within a week, Reimburssence will transform the AR function.
It provides a level of transparency to the customer on the status of the follow-up process and its effectiveness – two areas that are opaque with competitor offerings.
Quintessence’s premise is that customers should only pay for progress and not clerical work that results in no reimbursement.
Reimburssence provides reports on:
- Touches enabling claim closure
- Number of touches per closure
- Denial type
- Staff performance
These reports help focus on relevant and modern measures that elevate performance and outcomes to a new level—metrics rarely discussed elsewhere in the industry.
The platform can also predict cash flows based on claims and payment history, assisting in workflow planning and inventory management of claims.
Proprietary Platforms for End-to-End RCM
Quintessence has built proprietary software for coding and AR follow-ups, as well as full-cycle functions that seamlessly work with customers’ PMS / EMR systems. This ability to plug in and wrap tools around customer platforms is a unique offering unmatched in the industry.
The company’s solutions go far beyond simple workflow systems. Codessence, Quintessence’s coding platform, is a machine learning CAC-based system that doubles radiology coder productivity and serves as a high-tech upgrade over basic workflows and reporting tools offered by competitors.
While the industry continues to focus on transaction counting of follow-up claims, Quintessence prioritizes practical touches to closure, algorithm-based claim queue building, and intelligent allocation.
Their tools also enable automated support systems for appeals and resubmissions, significantly improving staff productivity and effectiveness in the follow-up process.
In short, clients pay only for good work—and unlike competitors, do not pay for errors or mistakes.
“We are deploying machine learning and algorithms in Codessence and Reimbussence respectively. We also built our own BOTs that have taken over repetitive high-volume tasks. We have also configured and deployed third-party BOTs in environments like Citrix and in PMS like EPIC, Intergy, and Kareo,” adds Nirmal.
Scaling Capabilities and Strengthening Partnerships
Quintessence is expanding its customer service and onboarding capabilities by strengthening front-end operations with a soon-to-open center in Dallas, Texas.
They are also partnering with hi-tech automation product suite companies to implement BOTs, while continuing to build proprietary BOTs to automate multiple Rev Cycle functions—enhancing their ability to work across a wide range of billing systems and EMRs.
Outcome-Aligned RCM Services
Quintessence offers packaged RCM services aligned with EMR companies, delivering a seamless single source of service excellence. The company guarantees outcomes for customers who onboard with their full services suite.
“And unlike the competition, we are a partner to our customers as we work with the same contractual SLAs that our customers are subject to,” explains Nirmal.
“The contingency or success fee model (% of collections) that we propose on full-cycle services means we are aligned with our customer’s business and share their risks and rewards. This is greatly different from the general transaction-based / FTE-based pricing models prevalent today, which do not penalize poor outcomes and errors.”