New Cloud SaaS Solution Designed to Prevent Billions in Waste, Transform Healthcare Administration
Burgess, a leading cloud-based solution provider serving healthcare payers, introduces Burgess Source, a first of its kind platform that natively brings together payment integrity, pricing, contract terms configuration, audit and real-time business intelligence. By combining these fragmented elements into one system, Burgess Source is the most effective way to prospectively avoid inappropriate and inaccurate reimbursement, maintain a point to point compliance trail and model healthcare payments.
According to the Harvard Business Review, the U.S. healthcare system would save $130B if insurance administrative complexity were reduced to the same levels as other service industries. Moreover, the American Medical Association (AMA) reports that it would save the system $14B if every claim was paid correctly the first time.
Incorporating technology to solve many of these industry inefficiencies, the Burgess Source platform is built from the ground up to eliminate non-communicative disparate point solutions and promote a new standard in transparency and payment accountability. The unique design also models claims data, providing real time business intelligence, helping ACOs and health plans make smarter decisions. Highly configurable, it allows users complete control to adapt the platform to each plans’ specific requirements while the Burgess Source team keeps the data and regulatory policy management up to date and compliant.
Currently 17.8% of every premium goes to operating costs, according to AHIP’s Center for Policy and Research. By shifting money from inefficient and inaccurate payment transactions to delivering high quality defensible business outcomes, Burgess Source is designed to promote lower costs and innovate operations across the industry.
“Non-communicative payment platforms lead to waste, repeat work and frustration among payers, providers and members. Through advanced and previously unavailable technology, analytics and a sophisticated data delivery model, we’ve reinvented the current complex claims payment integrity and pricing process to dramatically improve first pass payment accuracy and compliance, which impacts all stakeholders in healthcare,” says Greg Burgess, Founder and Chief Product Officer at Burgess. “Burgess Source will provide a new standard in payment accountability, which was previously non-existent,” he adds.
Burgess Source is reinventing reimbursement and accountability between payers and providers to:
- Prospectively limit errors and markedly improve payment accuracy through cost avoidance.
- Improve operational efficiencies and financial performance.
- Maintain for instant recall a claim’s full audit trail including regulatory citations, the specific contract terms in effect when processed, all payment integrity edit definitions, and pricing terms employed at the exact moment the claim is processed.
- Promote transparency and accountability with providers while supporting both internal and external audits.
- Monitor the impact of policy changes before making them with real time analytics.
- Offer “what if” scenarios using historical claims data to model various services using comparative analytics.
- Limit rework by parallel processing all payment integrity edits in a single pass to tell a provider everything that’s right or wrong with a claim.
Burgess operates at the intersection of healthcare, finance and technology. The company helps leading American health insurers and ACOs set a new standard: Payment Accountability. The company’s cloud-based platform, Burgess Source, is the only solution that natively brings together up-to-date regulatory data, claims pricing and editing, and real-time analytics tools. This unified approach allows clients to make payments with total confidence, and make business decisions with real intelligence. The company is headquartered in Alexandria, VA and online at burgessgroup.com.