Policy Reporter by Mercalis Introduces Payer Compliance Dashboard

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Aug 15, 2024, 10:30 ET

Tool helps Hospitals, Health Systems, and Physician Practices Address Financial Impact of Payer Denials

MORRISVILLE, N.C., Aug. 15, 2024 /PRNewswire/ -- Policy Reporter by Mercalis, a leading provider of payer intelligence to the healthcare industry, recently launched its Payer Compliance Dashboard (PCD).

The PCD addresses the widespread issue of claim denials that impact the clinical and financial performance of hospitals, health systems, and physician practices. Policy Reporter is uniquely suited to address these challenges utilizing proprietary and patented technology, teams of experienced healthcare analysts, and a robust database of active and historical payer documents. The Payer Compliance Dashboard provides a curated view of payer claim submission requirements to save staff research time and eliminate manual tracking tools.

The Experian Health State of Claims Survey (2022) states that 67% of providers cite "more frequent payer policy changes" as their top reason for denials.¹ Consulting firm Premier reports that addressing denials and keeping up to date on payer requirements and published documents costs the industry approximately $19 billion in administrative burden annually. With roughly 15% of initial claims submitted to payers being denied, the average administrative cost per denial is estimated at $44.²

Using the PCD, contract managers can better understand and negotiate complex claims payment rules. Physician advisors and utilization review professionals will gain access to peer-to-peer guidelines, helping align payer and provider goals. Billing and coding staff, along with practice managers, benefit from proactive alerting and an easy-to-use interface. Denials and appeals management teams can investigate and preempt future denials by tracking policy changes.

The PCD includes commercial payers as well as Medicare and Medicaid and contains both extracted data points and links to full payer documents, outlining the answers to key business questions in an easy to use and centralized format.

Policy Reporter recently debuted the PCD at the Healthcare Financial Management Association (HFMA) annual conference in Las Vegas, NV from June 24-27, where it was met with widespread positive reception from hospital and health system revenue cycle leaders.

"One of the nation's largest health systems has recognized the value of our PCD tool and invested in our partnership," said Tim Ogren, General Manager and Head of Sales at Policy Reporter. "This immediate vote of confidence in our solution is indicative of how this tool addresses a critical problem for healthcare providers by providing them with specific actionable data."

To learn more about the PCD and all of Policy Reporter's payer intelligence and tracking tools, contact us at [email protected].

About Policy Reporter

Policy Reporter provides innovative healthcare software solutions to track payer policies in near real-time and enhances market access for the therapies patients need most. The company's patented software-driven solutions include a suite of billing and reimbursement tools for providers and laboratories, market intelligence tools for payers, and a suite of market access solutions for life sciences companies. Its clients include some of the world's largest pharmaceutical and healthcare companies. For more information or a free demo, please visit https://www.policyreporter.com.

About Mercalis

Mercalis is an integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. The company partners closely with its clients to deliver an end-to-end spectrum of commercial capabilities that work together seamlessly and flexibly. Backed by proven industry expertise and results-driven technology, Mercalis provides the data and strategic insights, patient support services, and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. Above all, Mercalis helps navigate the complex life sciences marketplace to accelerate value and enhance patient lives. Founded in 2000, Mercalis provides commercialization solutions to more than 500 life sciences customers and has provided access and affordability support to millions of patients. The company is headquartered in Morrisville, North Carolina. For more information about Mercalis, please visit www.mercalis.com.

Allkire, M., Soumi, S., & Ingram, M. (2024, March 21). Trend Alert: Private Payers Retain Profits by Refusing or Delaying Legitimate Medical Claims. Premier Newsroom. https://premierinc.com/newsroom/blog/trend-alert-private-payers-retain-profits-by-refusing-or-delaying-legitimate-medical-claims
Experian Information Solutions, Inc. (2022) Report: The State of Claims 2022: Latest survey results from 200 executive healthcare professionals to shed light on the current claims environment [white paper] https://www.experian.com/content/dam/noindex/na/us/healthcare/state-of-claims-2022.pdf

Contact:
Landy Townsend
VP, Marketing & Communications
Mercalis
[email protected]

SOURCE Mercalis