Value-Based Care

Unlimited Financials supports the demands of value-based care

Value-Based Care

Capabilities that Unlock New Revenue Streams with Confidence

Unlimited Financials enables efficient and effective participation in the Advanced Payment Models currently transforming reimbursement of healthcare services. Financials eases the adoption of new Value-Based Care frameworks, including episode-based lump-sum payments, quality measure reporting requirements, and cost accounting to support risk-based agreements. Workflows and reporting are also optimized for established models such as capitation, case rate payment structures, and Division of Financial Responsibility (DOFR) arrangements.

Automated management of patient-specific treatment episodes –Unlimited Financials recognizes when the combination of a patient’s demographics, insurance coverage, and medical condition(s) qualifies their encounter for a treatment episode as defined by an Advanced Payment Model. Contract-specific billing events linked to the initiation or termination of the episode are also driven automatically via a configurable rules engine.

Conditional addition or suppression of line-item billing codes – whether achieved via systematic rule configuration or inherently ‘trained’ as a byproduct of recurring billing, Unlimited Financials conforms its claim and data outputs to comply with any novel format(s) required by Value-Based Care agreements.

Analytic tools designed to optimize contract performance – ensure that every Value-Based Care revenue opportunity can be accurately and independently evaluated. Rely on Unlimited Financials to make smarter decisions about your Advanced Payment Model portfolio.