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EXPLORE SIXA

Start your revenue cycle transformation journey with SIXA

Innovation is in Sixapart Healthcare’s DNA. Over the last few years, we have focused on developing automation that delivers business results -consistently and predictably. With an entire ecosystem of intelligent revenue cycle bots built on the latest machine learning and artificial intelligence technologies, we have truly brought the first-ever practitioner-developed automation platform in the revenue cycle space.

Improve productivity through increased automation and fast track implementation. 

Created by business process experts working closely with leading technologists, SIXA is Practitioner designed platform with well evolved use cases across the revenue cycle.

SIXA is a whole new way to look at the business of revenue cycle

The SIXA Automation suite comprises of the following:

Extensive business workflow enabled AI Platform

Overview:

The healthcare revenue cycle is a complex chain of interlinked business processes. From medical billing and Coding to accounts receivables, each of these processes presents multiple opportunities for healthcare providers to move from high-touch manual processes to digital operations by leveraging new generation robotic process automation capabilities. If you want to make a tangible and sustainable impact on the business results you seek, you must consider applying automation solutions across the revenue cycle continuum. 

As one of the providers of revenue cycle services, Sixapart Healthcare created an integrated, intelligent, and rapidly configurable automation platform, SIXA. With a comprehensive suite of pre-built bots available in its library, the application comes with a unique design studio to rapidly configure automation solutions and a control tower to monitor the effectiveness of the deployed bots.

 

Sixapart Healthcare’s SIXA is an extensive business workflow enabled AI platform that can create automation use cases on-the-go, and work with different industry-leading automation frameworks. The following elements make up SIXA.

A core design framework that enables rapid development and deployment of Bots
SIXA includes a dynamic assembler with a feature-rich design panel that provides quick Sixapart to variables, arguments, a library of process activities, and importing facilities. Designed to solve automation problems quickly, the design studio has to drag-and-drop features to build process-specific bots on the go.

SIXA includes a pre-built library of process activities that automate process components. The micro-bot’s library can be called within the design studio to visually stitch multiple process activities to create a process-specific automation solution.

SIXA utilizes a unique microservices-based framework that allows it to work with evolving automation frameworks and toolsets. The microservices allow echo to upgrade to new automation frameworks while giving us the ability to create scalable automation solutions.

SIXA implementations include a centralized control tower that provides a single panel view to monitor the efficiency and effectiveness of the bots in operation. With intuitive graphs and charts, the control tower provides a new level of control in

Designed by a team of revenue cycle practitioners and process automation thought leaders, SIXA brings a unique combination of pre-built process library and micro-services. What’s more, it includes pre-built revenue cycle use cases. These features enable echo to cut implementation time from months to weeks and utilize far less technical infrastructure in ongoing usage than most competing automation products.

With SIXA and Sixapart Healthcare’s proprietary Automation deployment framework, we can identify opportunities rapidly, configure and deploy automation solutions quickly, and monitor the performance of the deployed bots.

SIXA Benefits:

Built on industry-leading automation frameworks, the SIXA solution helps our clients accelerate their automation journey. The benefits SIXA offers to clients include:

ROBUST, FRAMEWORK THAT FUTURE-PROOFS YOUR AUTOMATION INVESTMENT
A mature process framework to build a clear roadmap for automation
A unique microservices-based architecture that gives SIXA the ability to leverage evolving technologies such as NLP, chat engines, etc., with little changes to toolsets, makes it future-proof.

EASE OF DEPLOYMENT
Rapidly deployable automation solution that leverages a comprehensive process activity library to automate process steps
A feature-rich design studio with a single-panel view provides a unified view of the entire automation project from design to deployment
Pre-built automation uses cases for most revenue cycle processes
Ability to shift automation agenda to Subject Matter Experts from development resources

MONITORING
A comprehensive monitoring solution that enables active management of the performance of the bots, with built-in alerts

REPORTING
Tight coupling with underlying workflow and knowledge management systems to improve monitoring of quality and throughput while ensuring the effectiveness of processing

COST OF OWNERSHIP AND RUNNING
The SIXA platform’s pre-built library of revenue cycle process bots, microservices, and design studio cuts implementation time to less than 50% of what is offered by the competition. In addition, the light build consumes far less server infrastructure than the competition.

AI Enable Payment Posting Platform

Built on industry-leading automation frameworks, the SIXA solution helps our clients accelerate their automation journey. 

The benefits SIXA offers to clients include:

Overview:
Healthcare remittances are delivered via Explanation of Benefit (EOBs) documents to transact payments between healthcare providers and payers. Unfortunately, the EOBs vary significantly among payers. The lack of standardization of image format, image quality, and the varying number of line items in each patient-physician encounter makes it a highly manual process to interpret and process large volumes of EOBs.
As a provider of healthcare revenue cycle services, Sixapart Healthcare processes over 10 M payment transactions per annum.
Sixapart Healthcare developed and deployed SIXA, an intelligent, automated payment posting solution. The solution eliminated almost all the manual tasks and errors associated with EOB processing. SIXA applies multiple technologies – optical character recognition, machine learning.
The SIXA platform addresses varying file formats across over 3,000 payers, differences in the number of line items in each Explanation of Benefits (EOB), and 1,000s of payer and provider-specific business rules, the task of processing over 10 M transactions p.a. can be very daunting.

FEATURES:

  • Automated sorting and batching of EOBs, application of multiple OCR engines, and comparison of captured data to ensure higher posting accuracy 
  • Recognizes over 3,000 payers and payer-specific EOB formats 
  • Addresses quality issues such as greyscale images, blurred images, etc. 
  • Rules-based identification of exceptions to allow manual intervention for processing exceptions 
  • Practitioner developed, pre-configured business rules for thousands of payers
  • Ability to recognize exception patterns, identify opportunities to add new rules, and reduce exception processing
  • Over 900 business rules to be used to classify, enrich, apply reconciliation logic, and post the captured data as per payer/provider guidelines
 
  • Application of machine learning tools to improve payer format recognition and reduce manual exception processing 
  • Utilizes machine learning to the onboarding of new payers with limited configuration efforts 
  • Output format compatible with the ANSI EDI standards, i.e., 835 and 837

AI enabled Denial Management, Eligibility Verification, Automated claims f/up
solutions:

Overview:
Let’s face it. Your A/R, denial management, and eligibility verification centers require costly resources. What if you had a way to make every minute count and not waste these resources on mundane tasks? SIXA brings you solutions to obtain claim status automatically, reduce prior authorization processing burden, enhance focus on denial resolution by using decision trees, reduce manual effort in filing appeals, and even make decisions on follow-up actions. Classify the claims as callable and non-callable. SIXA ensures that you work on the right claims at the right time and takes unnecessary pressure out of your revenue cycle call center.

We provide below some of the use cases we solve through SIXA.

  • Call Documentation consistency improvement                                                                          
  • Create decision trees for each calling scenario
  • Automate claim status from payer portals                                                                                   
  • Prepare and file appeals

Post-call notes hold valuable information, such as the reason for the call, the outcome of the call, specific updates, customer feedback, next steps, or follow-ups. An A/R call center agent must place accurate notes on the system after following on accounts receivable claims with Payers. With multiple agents following up on different accounts with different payers, the call notes do not follow any standards. Lack of standardized call notes makes it difficult for the agent, who picks up the same claim next time, to understand the call notes and initiate resolution actions.
SIXA automates the post-call documentation work through an interactive documentation tool that includes:

  • Pre-built template for every call scenario that requires minimal effort in capturing call notes
  • Allows editing of the documentation and manual interventions for processing exceptions
  • In some scenarios, echo can also complete certain post-call work items on the customer’s revenue cycle system

SIXA simplifies and standardizes the post-call documentation work. It also improves the productivity and accuracy levels of the agents working on the accounts receivable and subsequent business processes. Typical results include:

  • 30% reduction in the post-call documentation error and save time
  • Improved consistency of post-call documentation
  • Quality delivered at 99% accuracy for documentation, posting, and retrieval
  • The output formats adhering to the client’s requirements

SIXA DECISION TREE
Business Processes often require a series of steps to arrive at the right decision. SIXA decision tree empowers supervisory staff to pre-define process steps to collect information at each step of the business process and for each scenario. Thus, it enables the collection of the required information at each step of the process.

  • A workflow-based solution that gathers required information from the user and presents the solution sequentially to complete the scenario
  • Integration of knowledge from various subject matter experts, process manuals, procedures, and referenceable documents to develop a scenario-based rule for the business processes
  • Decision Time gathers all the required information from the user about each case to match with existing cases on the system.
  • Runtime is the real-time configuration of the data that is presented to the user with the relevant references and use-cases to complete the scenario successfully.
  • In-built reporting allows the supervisor to track the number of cases in the inventory, the steps of activities performed using the real-time cases, and identify the missing case types for future addition.

Typical results that our clients see:

  • Improved productivity of denials and A/R management calls by 10%
  • Reduction in errors by 2-5%
  • Improved standardization of processes across and within the business verticals
  • Improved consistency and reliability of the service delivery outcomes
  • Eliminated delays due to waiting for supervisory intervention for complex scenarios

SIXA AUTOMATED CLAIMS STATUS
Hundreds of Payers now provide claim status online. However, the problem lies with automating the status of the claim check information in a HIPAA-compliant manner. SIXA includes secure login management and robotic process automation architecture that fetches data from the Payer websites using assisted and unassisted automation.
Benefits:

  • HIPAA compliant secure information extraction
  • Reduction of labor costs and improved productivity
SIXA APPEALS MANAGEMENT
Timely appeals filing is critical to the success of denial management and reduction projects. However, the lack of standardized templates across payers is a common problem that makes automation of appeals filing difficult.  As manually filed appeals are prone to data capture errors and quality issues, which eventually leads to denial of appeals. These problems contribute to lapses in appeal filing limit timelines.
With SIXA appeal filing automation module, SIXA auto-creates the appeal documents. It fetches and auto-populates data points from the A/R inventory into the payer-specific appeal templates. The solution also merges and uploads relevant clinical and billing documents to the payer website.
Typical results that our clients see:
  • Reduction in the manual effort by 75%
  • Reduced average handling time by 16%
  • Increase in quality by 3-5%

Check your practice health by data

Overview:
As many as 96% of the healthcare CFOs feel that they need better financial and operational data analytics to optimize their revenue cycle. Built on HFMA MAP keys, an industry-standard definition of different revenue cycle KPIs, SIXA lets you take back control of your revenue cycle.
As declining reimbursements, rising bad debt, and lower margins becoming the norm, healthcare organizations must extract the maximum value from their revenue cycle. Whether you are a revenue cycle services aggregator or a health system, intuitive revenue cycle dashboards based on industry-standard KPIs can help you better understand the financial health of your organization and make data-driven decisions. Hospital CFOs and revenue cycle operations leaders looking to improve the organization’s financial health need multivariate views of the information to track cash flow, allocate operational resources, focus on high-impact areas, and develop financial plans.

Key performance indicators (KPIs) such as aging buckets, collections, total claims in process, average days in A/R, charges by facility/provider, bad debts, and top denial reasons define the revenue cycle’s health. By providing intuitive dashboards of these metrics to operations leaders and CFOs, one can help them make more informed staffing decisions and focus on achieving business outcomes.
The revenue cycle is a statistician’s delight, and over 30 different KPIs are generally used to illustrate its performance. Adding to this is the complexity of representing the KPIs over multiple time frames to perform trend analytics.
While reports are available on most underlying revenue cycle systems, dashboards and charts that empower CFOs to make the right decisions are usually lacking. Further, these dashboards utilize 100s of reports to create multi-variate views of revenue cycle performance. Business Intelligence tools aggregate data from different reports to build custom dashboards for various revenue cycle decision-makers in the organization.

SIXA lets you take back control of the revenue cycle. Imagine a tool that refocuses your workforce on achieving best-in-class revenue cycle KPIs. With strong data visualization tools, SIXA answers many of the problems hospital CFOs and revenue cycle services providers are looking to solve. With the ability to cut down report generation time from days to minutes, the business intelligence capabilities of the tool shift the focus to problem-solving and decision making from report generation. Further, with tight integration with revenue cycle workflows, SIXA can create SMART WORK QUEUES for your operations team to focus on to make a tangible impact on your A/R inventory.

  • Extract specific data fields from tables in excel files from multiple folders or multiple reports within your revenue cycle system
  • Make structural changes, alignments, etc. to standardize the format for tables across clients
  • Push data to the server

 

  • Pulls data from the revenue cycle system into PowerBI
  • SIXA has pre-built Data Analysis Expressions (DAX) models within PowerBI to perform calculations
  • SIXA has pre-built Data Analysis Expressions (DAX) models within PowerBI to perform calculations
  • Automatic refresh of the reports set-up to show updated data every month
  • End-to-End automation from data extraction to computation and visualization
  • Streamlined month-end processing with the ability to generate reports with a single click
  • Live dashboards with the ability to slice-and-dice the data across different dimensions 
  • Data repository with monthly data for the past three years are built-in to make YoY, QoQ, and MoM comparisons readily available for the users 
  • Visuals with drill-down capabilities to Claim/CPT level information helps business users to make key decisions 
  • Automated calculations meant almost zero errors reducing efforts on quality checks 
  • User-based secure access provided to each of the Practice/facility Managers and Physicians