# Hospitals and provider groups — Radexus

> Claims come back for the same reasons every month and nobody has counted them. Nothing here touches clinical decisions.

*Source: https://radexus.com/industries/hcp/*

---

[Industries](https://radexus.com/industries/)  /  Hospitals and provider groups

# Claims come back for the same reasons every month. Nobody has counted them.

Claims come back for the same reasons every month and nobody has counted them. Nothing here touches clinical decisions.

Claims come back for the same reasons every month and nobody has counted them. Nothing here touches clinical decisions.

## Where the money goes in hospitals and provider groups.

Most of a hospital group's patients arrived because a doctor recommended it, and that referral map exists in individual heads rather than any system. Claims are denied on first submission for a handful of recurring reasons that nobody has tabulated. Follow-ups happen when the patient remembers rather than when the record says they are due. None of this is clinical, and we stay well clear of anything that is.

## What the first hour looks like, and the number we would agree.

First meeting, no data from you

Referral concentration from your own registration data: which referrers your best patients came through, and which have gone quiet.

The number we would propose

First-pass claim acceptance rate, or new patients per mapped referrer.

Why that one

Denials are the cleanest bottom-line number in the sector. Referral mapping is the cleanest top-line one. Neither touches a clinical decision.

## 6 plays in the catalogue for this sector.

Each one is built from the same nine patterns and reads the same memory. The first is priced as a pilot. Every one after it runs on a memory that already exists.

-   **Acquire**Referral network mapping
-   **Retain**Patient recall and follow-up
-   **Operations**No-show and slot utilisation
-   **Finance**Claim denial and rework
-   **Finance**Payer and TPA receivables
-   **Finance**Consumables and procurement spend

## Systems we read in this sector.

Nothing is migrated. A connector that does not exist yet is written during delivery and joins the library.

NapierInsta by PractoAttuneSuvarnaKareXpertMedixcelEpicOracle HealthMEDITECHathenahealthTPA and insurer portalsWaystar and Availity

## Bring four customer names. We run the first play before we meet.

[Start a discovery](https://radexus.com/start/)[Model the value](https://radexus.com/?preset=service#calc)

[Next sectorManufacturing and machine tools](https://radexus.com/industries/mfg/)