80% of all medical
bills contain errors*
What if you could catch coding
errors prior to billing?

PwC SMART® (Systematic Monitoring and Review Technology) increases the efficiency and effectiveness of your inpatient and outpatient coding quality evaluation process, and enables a mechanism for quality and compliance review. Coupled with the support provided by PwC Health Information Advisory, SMART bolsters your efforts to monitor coding and data quality.

*Source: "Medical Billing." Healthcare Business & Technology, 2019
 
 
80% of all medical bills contain errors*
What if you could catch coding errors prior to billing?

PwC SMART® (Systematic Monitoring and Review Technology) increases the efficiency and effectiveness of your inpatient and outpatient coding quality evaluation process, and enables a mechanism for quality and compliance review. Coupled with the support provided by PwC Health Information Advisory, SMART bolsters your efforts to monitor coding and data quality.

*Source: "Medical Billing." Healthcare Business & Technology, 2019
 
The SMART® way
to tackle coding errors
SMART
Inpatient

SMART Inpatient includes 1,000+ pre-defined business rules that identify potential coding inaccuracies and documentation improvement opportunities. You can also customize business rules for your specific areas of focus. Reporting and data analysis help you evaluate your staff’s performance and pinpoint education opportunities for Coding, Clinical Documentation Improvement (CDI), Quality and Providers.

SMART
Outpatient

SMART Outpatient improves the accuracy of claims and identifies charge capture issues and areas for workflow improvements. It also improves regulatory compliance by decreasing the risks caused by inaccurate coding across all ambulatory services and selected areas, such as emergency departments or observation patients.

SMART
Professional

SMART Professional, coming later this year, will leverage the proven success of our coding accuracy workflow to analyze 100% of claims for all medical specialties and services. Coding and billing related edits will be designed to both improve coding and charge capture and reduce compliance risk. Custom reports will give management insight on areas to focus physician education, outliers compared to peer benchmarks and E&M profiling.

 
 
The SMART® way
to tackle coding errors
SMART
Inpatient

SMART Inpatient includes 1,000+ pre-defined business rules that identify potential coding inaccuracies and documentation improvement opportunities. You can also customize business rules for your specific areas of focus. Reporting and data analysis help you evaluate your staff’s performance and pinpoint education opportunities for Coding, Clinical Documentation Improvement (CDI), Quality and Providers.

SMART
Outpatient

SMART Outpatient improves the accuracy of claims and identifies charge capture issues and areas for workflow improvements. It also improves regulatory compliance by decreasing the risks caused by inaccurate coding across all ambulatory services and selected areas, such as emergency departments or observation patients.

SMART
Professional

SMART Professional, coming later this year, will leverage the proven success of our coding accuracy workflow to analyze 100% of claims for all medical specialties and services. Coding and billing related edits will be designed to both improve coding and charge capture and reduce compliance risk. Custom reports will give management insight on areas to focus physician education, outliers compared to peer benchmarks and E&M profiling.

The SMART difference
Customizable to fit your needs

Unique flexibility to reconfigure processes, edits, and settings.

Visibility into what can get better

Easy to identify opportunities for ongoing operational improvements through data analysis and reporting.

Time-saving automation

Seamless audit tracking to review past results and monitor the progress of all ongoing audits.

The SMART difference
Customizable to fit your needs

Unique flexibility to reconfigure processes, edits, and settings.

Visibility into what can get better

Easy to identify opportunities for ongoing operational improvements through data analysis and reporting.

Time-saving automation

Seamless audit tracking to review past results and monitor the progress of all ongoing audits.

Success starts with SMART
Get the right reimbursement

Alerts your staff when there are potential coding errors or opportunities which gets your billing out the door quicker.

Meet regulatory requirements

Multiple updates to include revised filters and new proprietary flags targeted to reduce the risk of errors stemming from new coding rules and standards.

Make your team more efficient

Automates the review process so your staff can cover more cases and simplifies the coding evaluation process, allowing for more efficient use of scarce or costly coding auditor resources.

Success starts with SMART
Talk to the people behind SMART

With 25+ years in the market, SMART is built on decades of coding and billing process work resulting in the most extensive business rules in the market. Talk to our team about what SMART® can do for you.

"It's difficult for our clients to review thousands of claims before they bill. SMART flags help them to pinpoint which cases need a second look and reduce time wasted on those with no errors."

"SMART really shines when you bring in new coding staff because it can closely monitor their accuracy and identify areas of concern so that training can be provided quickly."

"You have to be ready to respond in a timely manner. But I think a better way to prepare yourself is to determine how to stop denials from happening in the future. That is where SMART comes in to maximize accuracy and reduce rework."

Talk to the people behind SMART

With 25+ years in the market, SMART is built on decades of coding and billing process work resulting in the most extensive business rules in the market. Talk to our team about what SMART® can do for you.

"It's difficult for our clients to review thousands of claims before they bill. SMART flags help them to pinpoint which cases need a second look and reduce time wasted on those with no errors."

"SMART really shines when you bring in new coding staff because it can closely monitor their accuracy and identify areas of concern so that training can be provided quickly."

"You have to be ready to respond in a timely manner. But I think a better way to prepare yourself is to determine how to stop denials from happening in the future. That is where SMART comes in to maximize accuracy and reduce rework."

The real impact of SMART

As a result of corrections identified by SMART, the net reimbursement impact across the enterprise was $1.8M.

Healthcare provider network

PwC brings a sophisticated approach to customer insights on a leading platform. PwC aims to be a one-stop shop for healthcare analytics and professional services.

The Forrester Wave™
Healthcare Analytics, Q4 2018
Read the Forrester report here.
Let’s talk about what SMART
can do for you
Let’s talk about what SMART can do for you
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