Intelligent Healthcare Revenue Optimizer
Surface HCC gaps, track RAF score impact, and send ready-to-act worklists to your team. Improve value-based performance without the busywork.
Connect your claims, clinical, and quality data into a single source of truth, and OptimIQ continuously surfaces risk and care gaps, flags payment and utilization issues, and delivers ready-to-act worklists—so risk adjustment accuracy, value-based performance, and claims integrity all improve without extra busywork.
A Unified Suite Built for Modern Healthcare
Comprehensive solutions to optimize your healthcare revenue cycle
Value-Based Care Metrics
Intelligence platform with validated NLP and ML models identifying HCC gaps and optimizing RAF scores through comprehensive HIE integration.
- V28 HCC gap analysis
- RAF score optimization
- Quality care gap alerts
- VBC metrics tracking
RAF Score Analytics
HCC Gap Analysis Dashboard
HCC Gap Analytics (Last 5 Months)
Open HCC Gaps (V28)
Diabetes w/ Complications
Congestive Heart Failure
COPD
Chronic Kidney Disease
Post-Acute Optimization
High-accuracy disease burden capture for SNFs and home health agencies with audit-ready recommendations.
- Comorbidity identification
- Revenue opportunity flags
- Operational efficiency insights
- Audit-ready documentation
SNF Performance
Disease Burden Capture
Comorbidity Capture Pipeline (Last 6 Months)
Top Comorbidities Identified
Claims Intelligence
Real-time eligibility verification and predictive analytics for denial prevention and revenue optimization.
- Real-time eligibility checks
- Denial risk prediction
- Cost estimation & rate comparison
- Clinical insights before visits
Claims Intelligence
Real-Time Eligibility
Claims by Risk Category Distribution
Claims Success Rate
How It Works
From data integration to revenue optimization in four simple steps
Connect & Integrate
Seamless integration with your existing EHR, PMS, and clearinghouse systems. Our platform connects via secure APIs, HL7/FHIR protocols, or direct database access—whatever works best for your infrastructure.
Analyze & Extract
Our NLP engine processes clinical documentation to identify missed diagnoses, incomplete coding, and revenue opportunities. Validated AI models ensure every recommendation is clinically accurate and compliance-ready.
Validate & Prioritize
Human experts review AI-generated recommendations to ensure clinical validity and compliance. Opportunities are ranked by revenue impact, documentation strength, and audit defensibility.
Deploy & Capture
Actionable insights delivered directly into provider workflows. Updates pushed back to EHRs via reverse interfaces, enabling one-click documentation improvements and immediate claim submission.
