#USA #Franklin #EnableComp #Helix Advisory #revenue recovery

EnableComp's Strategic Acquisition of Helix Advisory

In a significant move to bolster its position in the complex revenue cycle management sector, EnableComp, a leading provider of technology-driven solutions, has acquired Helix Advisory, a Cincinnati-based revenue recovery firm. This acquisition marks a pivotal expansion in EnableComp's Zero Balance Review capabilities, enhancing its robust platform designed for hospital clients dealing with complex claims and revenue recovery processes.

Enhancing Revenue Recovery Solutions

The integration of Helix Advisory’s innovative technology into EnableComp’s existing systems is set to transform how underpayments are identified and resolved. Traditional revenue recovery methods often fall short, missing substantial amounts due to their reliance on predetermined rules and thresholds. EnableComp's acquisition of Helix allows its platform to now detect underpayments that standard audit procedures might overlook. This unique capability distinguishes Helix's technology, which can identify discrepancies that even the most sophisticated rules-based systems cannot capture.

EnableComp's CEO, Frank Forte, emphasizes the importance of this acquisition: "Most recovery programs are built to find what they're told to look for. Helix's technology finds what nobody told it to look for — that's the difference between a rules engine and real intelligence." By incorporating Helix’s advanced functionality, the company aims to eliminate the common problem of hospitals leaving significant revenue unclaimed due to complexity or size of the claims.

Addressing Hospital Underpayments

The challenge of hospital underpayment is a major issue across the U.S. healthcare landscape. According to data from the American Hospital Association, hospitals are underpaid by over $130 billion each year from Medicare and Medicaid alone. Commercial payers exacerbate this issue, often leading to revenue that remains unrecovered. The crafting of Helix’s technology was specifically aimed at detecting this lost revenue, enabling healthcare providers to recover funds that would otherwise go unnoticed due to the restrictions of standard auditing practices.

Zack Higbie, the founder of Helix Advisory and new vice president of Revenue Recovery Products at EnableComp, notes that their technology was meticulously designed to highlight revenue that traditional recovery initiatives miss. The collaboration between EnableComp and Helix is expected to significantly amplify the revenue recovery potential for hospitals, some early users already reporting over a 2% net revenue improvement from previously unrecognizable funds.

A Unified Approach to Complex Claims

For EnableComp’s existing hospital clients, this integration simplifies the recovery process. Where manual audits once stood as the gatekeepers for smaller or more complex claims, this new framework means that all underpayment recoveries will occur natively within the same platform that addresses complex claims and denials. This holistic approach not only enhances efficiency but also empowers hospitals to prevent future losses rather than merely responding to past discrepancies.

EnableComp continues to support over 1,000 hospitals across the nation, recovering around $3 billion annually through its targeted Complex Claims, Complex Denials, and Revenue Recovery solutions. The firm has established itself as a leader in the industry, having been recognized as Black Book's #1 Specialty Revenue Cycle Management firm for complex claims for three consecutive years.

Conclusion

The acquisition of Helix Advisory is a forward-thinking step that showcases EnableComp’s commitment to innovation within the revenue cycle management landscape. By advancing its platform with cutting-edge capabilities and tackling the perennial issue of hospital underpayments, EnableComp is setting a new standard and paving the way for greater financial recovery in the healthcare sector. As the integration efforts proceed, both existing and future clients can anticipate a marked improvement in their revenue recovery operations, potentially saving millions in overlooked claims.