WorkDone Health offers an AI-powered platform that monitors hospital EHR activity logs in real-time to ensure clinical protocol adherence and identify billing inaccuracies. The system proactively flags deviations, enabling immediate corrective action and automating revenue reconciliation to reduce regulatory risk and capture missed revenue.
Funding
Funding not disclosed
Founders
Product
Problem
Hospitals face significant regulatory risk and potential revenue loss due to deviations from clinical protocols and documentation inaccuracies. Manual compliance monitoring is labor-intensive, prone to human error, and lacks real-time visibility, leading to missed billing opportunities and increased audit exposure.
Solution
WorkDone Health provides an AI-powered platform that integrates with hospital EHR systems to monitor clinical staff activity logs in real-time. The system captures timestamps for critical actions, such as medication delivery, and utilizes AI to identify deviations from established protocols. This proactive approach flags non-compliance before it escalates, enabling immediate corrective action and coaching. WorkDone Health also automates the reconciliation of clinical documentation with billing records, identifying missed revenue opportunities and streamlining the claims process. By providing automated audit trails and root-cause analysis for non-compliance, the platform enhances operational integrity and reduces regulatory penalties.
Target Audience
The primary customers are hospitals and healthcare systems seeking to reduce regulatory risk, improve billing accuracy, and enhance clinical protocol adherence across their departments.
Features
- Real-time AI analysis of EHR activity logs for protocol adherence monitoring.
- Automated flagging of missed steps and deviations in clinical workflows.
- AI-driven coaching and proactive alerts for clinical staff to correct actions in real-time.
- Automated reconciliation of clinical documentation with billing data to identify missed revenue.
- AI-powered review of claim packages to improve approval rates and payment amounts.
- Automated data retrieval from EHRs for resubmission of denied claims.
- Generation of comprehensive digital audit trails with time-stamped logging of protocol-related actions.
- Root-cause analysis engine to identify systemic issues contributing to non-compliance.
- Customizable dashboards and automated reporting for live visibility into compliance gaps and trends.
- Policy adherence tracking against standards such as CMS, Joint Commission, and HIPAA.