(US and Canada) Helix Advisory, a leading provider of revenue cycle management solutions, and ZignaAI, an innovator in AI-powered healthcare technology, announced a transformative partnership aimed at addressing the critical inefficiencies in healthcare revenue cycle processes. This strategic collaboration integrates Helix Advisory’s extensive revenue integrity expertise with ZignaAI’s advanced artificial intelligence capabilities in data analysis and natural language processing.

“This partnership is about delivering innovative, scalable solutions across the revenue cycle,” said Zack Higbie, CEO of Helix Advisory. “Providers are under constant margin pressures. As the complexity and volume of denials increase, the documentation burden on clinicians, required skill level of those combatting, and administrative costs all increase with them. Our combined expertise brings to market tools providers have long been awaiting. We’re excited to drive greater accuracy, compliance, and financial performance.”

This powerful combination offers healthcare providers a targeted approach to both inpatient and outpatient settings, including:

• Outpatient CDI Enhancement: Comprehensive charge capture backed by compliant documentation and coding for outpatient services, addressing the nuances of ambulatory care.

• Inpatient CDI & DRG Validation: AI-powered analysis of medical records ensures precise coding aligned with robust documentation. The system evaluates records against thousands of similar cases to flag inconsistencies and reinforce accuracy with “evidence of” language.

• Operational Streamlining: Utilizing automation to minimize review times, reduce manual workloads, and mitigate human errors, ensuring faster and more reliable processes.

• Proactive Denial Prevention and Management: Identifying root causes of denials at the source to optimize billing accuracy and prevent errors before submission. Retrospective reviews enable faster appeals and rebilling processes, enhancing revenue recovery rates.

The use of AI-powered insights and automation allows providers to flag and correct potential issues before claims are submitted, reducing rework and appeals, however the partnership also improves retrospective reviews, facilitating appeals and rebilling processes for faster revenue recovery.

“Our mission at ZignaAI has historically been to make revenue reviews smarter and more effective for payors,” said Lalithya Yerramilli, CEO of ZignaAI. “Partnering with Helix Advisory allows us to bring the counter of that approach to tackle critical areas like outpatient CDI, inpatient DRG validation, and claim accuracy, to providers, reducing complexity, preventing denials, and achieving optimal financial outcomes.”

A health system pilot has already begun demonstrating the partnership’s value, showcasing significant improvements in documentation review efficiency, cost reduction, and compliance.