Data and Analytics

Leveraging Key Insights From Data Analysis


Data is full of potential, but on its own, it’s just numbers. With the right partner, these numbers — denial rates, inpatient rates, CMI, and more — are transformed into insights to guide hospital and health system’s decisions regarding the clinical revenue cycle.

At Versalus Health, we’ve developed a portfolio of advanced analytic tools to close the gaps between utilization management (UM), documentation/coding, billing, reimbursement, managed care, and compliance.

Our data analytics utilize hospital encounter, billing, reimbursement, and patient status data and compare it against national benchmarks, hospital payer-specific contract terms, and billing rules to help answer questions like:

  • Are the strategies we use to minimize denials working?
  • What are the reasons for denials? Patient status, documentation, coding, or something else?
  • Are we complying with all the current post-Covid-19 Medicare patient status rules?
  • Do we have physicians that inadvertently drive compliance risk or revenue integrity risk?
The Versalus Health Data Analytics Approach

By combining encounter data, operational goals, market insights, and experience, we establish baseline measurements and create strategic plans to address specific problems and achieve desired outcomes. We receive data on monthly, weekly, and daily intervals, which we analyze using our library of proprietary algorithms. By transforming your encounter data, the Versalus Health dedicated Strategic Advisor can report actionable insights to drive financial and operational performance. These insights identify gaps and offer solutions across the blind spots of the clinical revenue cycle.

Keys to Program Success

Our data and analytics solutions follow a multi-dimensional approach to ensure successful client outcomes.

Performance Measurement and Advisory Services
  • Assess and compare clinical revenue cycle performance by facility, payer, and physician. Quantify sources of revenue erosion and compliance risk
  • Evaluate Net Inpatient Realization® — the net impact of payer denial tactics and hospital performance — by payer across revenue cycle functions
  • Conduct quarterly program performance reviews
Data-Driven Case Reviews
  • Guide concurrent admission status and documentation reviews & recommend intervention as needed (customized on a client-by-client basis and calibrated to client team structure/needs)
  • Follow all cases through our analytics platform to ensure compliance and revenue integrity
  • Perform targeted data-driven audits to identify compliance and revenue integrity risks and guide ongoing education
Ongoing Targeted Education & Support
  • Conduct education sessions for Utilization Management, Physician Advisors, Attending Physicians, Business Office, HIM, and Managed Care targeted to address root causes of problems based on data analytics
  • Review findings to drive compliance excellence and optimize revenue integrity
  • Provide case-level feedback to clinical and revenue cycle teams
Dedicated Expertise

To facilitate the progression from data analytics into action and results, Versalus Health assigns a Strategic Advisor to each client. Our Strategic Advisors “translate” analytics into action plans and work with department leaders to assess performance, implement tactics, track outcomes, and deliver results. Our Strategic Advisor will work side by side with you as an extension of your internal team to put your clinical revenue cycle strategic plan into action.

Whatever changes lie ahead, Versalus Health will help you navigate them. A partnership with Versalus Health will help you realize revenue integrity while safeguarding the future.

We have you covered, no matter how things change.

Are you ready to improve your revenue cycle through healthcare data and analytics? Contact Versalus Health today to book a strategy call.

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Learn how Versalus Health’s innovative appeal solutions can drive increased revenue for your hospital.

Physician Advisors

Physician Advisors

Today’s hospitals and health systems require physician clinical expertise tied to in-depth knowledge of documentation best practices, length of stay management, quality, contracting, billing, and compliance, among other disciplines. Hospitals and health systems have invested significantly in building internal Physician Advisor teams to address these needs.

Regulatory Compliance

Regulatory Compliance

Regulatory compliance is a complex issue for many healthcare facilities, especially as new, updated regulations supersede old ones. Hospitals and health systems may find it challenging to stay up to date with regulatory changes impacting Utilization Management (UM) and the clinical revenue cycle and determine the implications of these regulatory changes on the organization’s processes. Fortunately, Versalus Health can assist your organization with keeping up to date with regulatory changes. We keep our finger on the pulse of regulatory oversight, helping facilities understand the newest regulations, their implications for the Clinical Revenue Cycle , and the latest trends in audits