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Claimocity: Innovation that Empowers Medical Professionals

Jim Sholeff, CEO of Claimocity.

The intermingled conjunction between healthcare and technology, from the invention of the pacemaker to the modern methodologies of leveraging big data to evaluate diagnostic probabilities, provides a critical foundation for forward-thinking medicine to build upon.

One of the most fascinating modern applications of healthcare technology injects the current evolution of machine learning into historically burdensome administrative and billing systems, utilizing the processing power of custom artificial intelligence designs to streamline complex workflows and handle a huge array of ancillary needs in a manner that enables doctors to shift their primary focus back to simply providing the highest quality of patient care.

This edition of the Top 10 Fastest Growing Healthcare Tech Companies of 2021 puts the spotlight on those organizations that facilitate the conjunction between medicine and tech by innovating products and solutions with the potential to change lives.

One prominent name among such companies is Claimocity, an AI-driven mobile practice management software platform built by veteran RCM medical billing service experts specifically to save high value time and make rounding doctor’s lives easier.

Formed in 2016 after nearly two decades of research and product development, Claimocity emerged with a singular purpose – to properly service the hospital-based community of doctors.

Listening to the needs of the physicians and practice managers, the company systematically identified every key pain point that was not being addressed. Then it isolated the variables and created the AI-enhanced tools, processes, and specialized teams needed to solve them.

“Our mission is to ensure that hospital and facility-based doctors are able to get more done in less time with better results – and collect 100% of what they have earned,” says Jim Sholeff, the Chief Executive Officer.

Setting Benchmarks

While they provide an array of highly regarded stand-alone options from charge capture to individual PM tools, Claimocity’s highest value offering rests in its all-in-one software and services solution, which reduces a physician practice from multiple vendors, integrations, and billing teams (in house or outsourced) to a single seamless end-to-end practical solution for clinical, administrative, financial, and managerial needs.

“One of the key advantages to a single high performing solution are the complete absence of integration stuck points, revenue gaps, and information loss issues that arise where multiple systems meet,” says Jim.

“By having a seamless flow from the point of care or system origin point to the claim completion and reporting functionality, there is a significant level of added intelligence and analysis available that increases efficiency and productivity opportunities while enabling the identification of growth and refinement points.”

“When you combine this level of data availability with a machine learning overlay and the higher processing power of artificial intelligence, and then run all of that through a robust support staff and multi-tiered levels of billing and audit teams, you get an unrivaled combination of experience and horsepower.”

“For example, with AI-enhanced quality control measures we can virtually eliminate lost, missing, or erroneous charges as well as identify coding inefficiencies that either result in lower revenue than the encounter should be generating or over coding audit risks that the provider and practice should be aware of,” he adds.

One of the revolutionary new offerings Claimocity has is the Progress Note Generator. Jim and the team state that the name is deceptively mild in comparison to the functionality and ability to save doctors money on other software.

To give a brief explanation, when a doctor sees a patient and an encounter happens, a doctor needs to generate a note into the EHR and provide administrative documentation about the encounter for billing purposes. These two separate things must happen for the physician to meet the medical requirements of the visit, and to get paid – the necessary administrative and billing duality behind every encounter. Claimocity combined the two into a single mobile workflow that integrates into the facility data system, saving high value time and eliminating the need for a practice side EHR for hospitalists.

The progress note generator (SOAP note generator) is built into the company’s charge capture workflow for practice management customers so that the same process they use for capturing a charge also generates, shares, and fulfills the progress note requirement in the facility EHR.

The custom rules engine and personalized software enables a wide array of easily modified templates, note cloning from past visits, note cloning from other coverage physicians, practice- or physician-level adjustments, and so much more.

“Every rounding doctor who has seen it in the demo so far has been thrilled by the possible applications and opportunities so it is one of those small changes that can have a big impact on so many workloads. And that’s truly what Claimocity is all about, making some meaningful changes that help the daily lives of rounding doctors,” Jim exclaims.

Exemplary Expertise

Jim Sholeff, the CEO, has been critical to Claimocity’s success, and as a founder member of the company, has been hands-on in product development, infrastructure development, and evolution of the company.

Jim’s leadership and vision have been two vital components in not only the steep upwards trajectory Claimocity has seen since the initial startup, but also the drive for massive internal growth that keeps everyone looking for new ways to improve small details, hit higher marks on already industry leading benchmarks, and to find new ways to provide higher value for the company’s existing customers. His hands-on approach makes him a favorite of new clients and interested parties who gravitate to his knowledge base and charm during demos and follow-ups.

In his advice to those aspiring to venture into the HealthTech space, Jim says, “Think outside the box and focus on detailed specialized values rather than broader solutions. The giants of the industry have had decades building recognizable brands and are very good at providing solutions to the broader markets. But when you provide products and services designed to cover as many customer bases as possible, you inevitably leave gaps where the solutions fall short.”

“For example, physician software covers a huge range of specialties and needs. And while some solutions overlap well across a variety of specialties, there are inevitably going to be certain segments of the market are going to find that their needs are not fully met. In fact, that is the very basis for Claimocity.”

“We noticed that hospital and facility-based physicians were having to utilize software and systems designed for office-based doctors but there are significant differences in workloads and workflows between physicians who primarily see patients in singular medical office settings and those who primarily perform encounters on the go in clinical settings like hospitals, step down rehabilitation facilities, skilled nursing centers, and other acute and sub-acute environments. To help them thrive, we systematically provided a set of products exclusively designed for their needs, helping hospitalists get more done in less time and collect as close to 100% of what they have earned as possible.”

Overcoming Adversities

Talking about how the COVID-19 pandemic impacted the HealthTech sector and how Claimocity pivoted to the remote setting to sustain operations, Jim says, “The effects of the pandemic on the healthcare sector have been brutal and we provided a great deal of support to our customers who in turn, are doing the same for their customers. Our doctors, physician groups and surgeons were heavily impacted in so many ways, whether from having contracted the virus and nearly succumbed, to having to temporarily shut down facilities, to undergoing massive shifts in their business models and personal approaches to their work, to the emotional toll it takes on them to be frontline responders to all the tragedies and constant state of turmoil and struggle that comes with such loss and pain.”

“Here at Claimocity, we were fortunate to have the infrastructure and resources in place to shift to remote with minimal impacts, and in fact our team really stepped up to support each other and logistically manage a massive transformation with no measurable downtime.”

“For example, when COVID struck, we were able to move 88.3% of the medical billing and coding workforce around the globe to fully secure work environments with no significant loss of production. To put this in perspective, that’s thousands of people shifting from central hubs to independent locations requiring new equipment, new software, different wireless connections, security implementation measures, new SOPs, lines of communications, and clear plans of action.”

“To have less than a 3-hour downtime was a real testament to the dedication we have to both our team and our clients. Since we measure over 100+ in-process metrics, we were able to monitor how the physical changes impacted the data and trend lines, and we were so proud of the team to see the numbers not drop off but rise slightly as everyone banded together to do more and cover for each other,” Jim expressed.

Exhibiting Excellence

Pertaining to Claimocity’s specific focus on hospital and facility-based physicians the company has received several notable recognitions from peer reviews and industry segments focused on hospitalists, physiatrists, inpatient psychiatrists, and rounding clinicians.

Today’s Hospitalist rated Claimocity head and shoulders above the rest as the top mobile charge capture app, as did PracticeSuite and Alliance for Academic Internal Medicine (AAIM), and the company saw a handful of other similar recognitions and awards from review based digital publications for their practice management tools and billing claims processing services.

“It’s amazing to get noticed for all the hard work we are doing as there are a lot of people in Claimocity working ceaselessly to put forth not just good products but amazing ones that they continue to refine and improve in every way possible,” Jim expresses.

“It is really a testament to the entire team when we get recognitions, but it is also an important aspect for us to increase awareness among hospitalists and rounding physicians that they don’t have to leave critical time and money on the table. When you are discussing tens to hundreds of thousands of dollars being lost annually to inefficient and outdated processes, it is critical that decision makers have access to the key information they need to make an informed decision,” he adds.

Towards a Successful Future

We asked Jim about his vision for scaling Claimocity’s operations and offerings in 2021 to which he said, “This is a great question and one that really strikes a chord. We have some big things in the works that have been in R&D for several years now and are in the final stages of development that are going to change the industry. Many times, a company will say ‘change the industry’ but in reality, the results fall far short of the hype. In this case, I am understating the possible impact as there are simply no other products like it in the market in any specialty and it should become the centerpiece of the company moving forward. Because of the timing, it is not yet ready for disclosure, but I think it will be a fun topic to discuss in next year’s interview.”

“As for general thoughts on scaling, we have already seen strong growth in the last year, and especially in the last six months, and we have so many irons in the fire that it will be exciting to see how many of them, we can complete and roll out in the final two quarters of 2021,” concludes Jim.




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