Policy Pulse helps you stay ahead of policy shifts that impact reimbursement, operations, and financial performance, before they show up in your KPIs. It surfaces what matters, connects it directly to your reality, and helps your team act with confidence.

• Monitors new and upcoming payer policy changes enterprise-wide, summarizes what changed by NPI with provider-specific and contract-level nuance, and scores which changes matter most based on operational and financial impact.
• Connects policy changes to 835/837 claims data to identify impacted accounts, claims, departments, codes, and service lines, while forecasting net revenue impact before effective dates to help prevent avoidable denials.
• Guides cross-functional action across billing, coding, pre-service, managed care, and revenue integrity by flagging who is impacted, what action is needed, and how workflows, documentation, coding, and pre-service processes should be updated.
• Performs retrospective payment analysis to verify reimbursement against contract terms, quantify underpayments and revenue leakage, and support recovery efforts as well as stronger future payer negotiations.
• Supports enterprise scenario modeling by region, state, payer, and volume to assess risk under different conditions, and measures results over time through first-pass yield improvement and avoided revenue loss.
• Get guided answers from our interactive AI agent, powered by our Ana Intelligence Engine, to interpret payer policy changes, understand financial impact, ask questions in real time, and receive recommended next best actions to operationalize and adhere to changes.

No more digging through payer portals. No more learning from hindsight. No more scrambling after the fact.