Analytics

Revenue Intelligence

Denial management, payer contract analysis, and underpayment recovery. Every adjustment traced to root cause.

What You Get

Denial Management

Track first-pass denial rates. Trace every denial to root cause by payer, CPT code, and adjustment code. Know what's driving your denials before they become write-offs.

Underpayment Recovery

Identify claims where allowed amount exceeds what was received. Flag underpayments by payer and contract. Recover revenue you're already owed.

Payer Contract Analysis

Measure actual reimbursement against contracted rates. Identify which payers are underperforming. Find leverage for renegotiation.

Adjustment Code Analysis

CO-45, PR-1, OA-23 breakdowns across your full claims volume. Know what's contractual, what's patient responsibility, and what's recoverable.

AR Performance

Days in AR by payer, clean claim rates, first-pass resolution rates. Track the metrics that drive your cash flow.

Board Reporting

Revenue cycle KPIs, trend analysis, multi-site visibility. Built for JVs, management companies, and academic medical center partnerships.

Exactrx Analytics

How the analysis works

From billed to banked, with nothing in between unexplained.

We trace every claim through the full reimbursement lifecycle so you can see exactly where revenue is slipping, and why.

Contracted

Expected reimbursement per managed care contracts

Modeled directly from your managed care contracts.

Collected

Net collections reconciled to the general ledger

Drawn from 835 remittance across every payer.

In-Network Gap

Recoverable in-network underpayment variance

Traced to payer, CPT, and adjustment code.

Before you commit to anything, we show you exactly where the gaps are and what's recoverable.

Every claim, traced to root cause

Billed vs. contracted vs. collected. We find the gap and tell you why.

Billed

$42,500

Total Knee Arthroplasty (CPT 27447)

Contracted

$10,500

Medicare FFS · ASC

Collected

$8,920

Per remittance (835)

Gap

$1,580

NCCI bundling edit

CO-97CO-59
Distinct secondary procedure bundled by NCCI edit; appealable with modifier 59 documentation✓ $1,580 recoverable
The view your CFO pulls before a JV partner meeting.

Payers we support

AetnaBlue Cross Blue ShieldCignaUnitedHealthcareHumanaMolina HealthcareCenteneAnthemAetnaBlue Cross Blue ShieldCignaUnitedHealthcareHumanaMolina HealthcareCenteneAnthemAetnaBlue Cross Blue ShieldCignaUnitedHealthcareHumanaMolina HealthcareCenteneAnthemAetnaBlue Cross Blue ShieldCignaUnitedHealthcareHumanaMolina HealthcareCenteneAnthemAetnaBlue Cross Blue ShieldCignaUnitedHealthcareHumanaMolina HealthcareCenteneAnthemAetnaBlue Cross Blue ShieldCignaUnitedHealthcareHumanaMolina HealthcareCenteneAnthem
Kaiser PermanenteTricareMedicareMedicaidAmbetterOscar HealthBright HealthDevoted HealthKaiser PermanenteTricareMedicareMedicaidAmbetterOscar HealthBright HealthDevoted HealthKaiser PermanenteTricareMedicareMedicaidAmbetterOscar HealthBright HealthDevoted HealthKaiser PermanenteTricareMedicareMedicaidAmbetterOscar HealthBright HealthDevoted HealthKaiser PermanenteTricareMedicareMedicaidAmbetterOscar HealthBright HealthDevoted HealthKaiser PermanenteTricareMedicareMedicaidAmbetterOscar HealthBright HealthDevoted Health

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See where your revenue is going.

We'll analyze your historical claims and show you exactly where the gaps are. Before you commit to anything.

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