Revenue loss from claim denials is a growing problem, with providers spending over $10 billion each year on managing denials. Here’s why building an effective denial prevention team can make all the difference: ▶ High Cost of Denials - The average cost to appeal a denial is $43.84, with each appeal taking up to 60 days. Medicare Advantage plans are particularly challenging, with over half of denials eventually overturned. ▶ Focus on Prevention, Not Just Management - Denial management is costly and time-consuming. A dedicated denial prevention team can address the root causes, reducing revenue loss and improving efficiency. ▶ Key Strategies for Success - - Analyze high-volume, high-dollar denials to find patterns. - Educate providers on common pitfalls and ensure adherence to coverage policies. - Implement workflow improvements and track progress to ensure sustainable results. ▶ Collaboration & Accountability - Working closely with managed care teams and leveraging data to hold payers accountable can enhance contract negotiations and improve outcomes. By focusing on prevention, healthcare organizations can protect their revenue, streamline operations, and achieve long-term financial sustainability. Are you considering a denial prevention team for your organization? #HealthcareFinance #DenialPrevention #RevenueCycleManagement #HealthcareInnovation #FinancialSustainability
Vault Bioventures
Business Consulting and Services
San Diego, CA 3,180 followers
Connecting innovation & healthcare markets to amplify pharma, biotech, medical device, & digital health company growth.
About us
We have one simple mission: To assist innovators improve patient lives by helping design and build highly differentiated products, launch and sustain better brands, and forge transformative and accelerated business models. Vault partners with you to create, develop, and reshape entire markets, shift therapeutic indications and treatment, and uncover missed or hidden asset, portfolio, and business opportunities. Unlike traditional life cycle consultants, brand agencies, & big box consultants, Vault’s experiential DNA helps foster and accelerate innovation in every phase across the product, brand, and business spectrum. We Work Across A Multitude of Healthcare Industry Segments: - Pharmaceuticals - Biotech - Medical Devices - 4th Industrial Revolution - Capital Markets, PE/VC - Food as a Medicine Vault provides you with strategic clarity through commercialization, clinical services, and business enablement, closing the executional loop with our with our medical affairs, marketing, advertising, and digital transformation divisions in our Strategy Plus model. Our expertise spans the therapeutic spectrum: - Obesity - Diabetes - Heart Failure - Gene & Cell Therapy - Autoimmune and Inflammation - Rare Disease - Infectious Disease - Pain Management - Central Nervous System - Oncology - Women's Health - Aging Health Cross-Functional Specializations - Endometabolic - Cardiometabolic - Endovascular - Cardiorenal - Nephro-Endocrine Visit our website to learn more about how we can work together to maximize the value of your innovation.
- Website
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https://www.vaultbio.com
External link for Vault Bioventures
- Industry
- Business Consulting and Services
- Company size
- 11-50 employees
- Headquarters
- San Diego, CA
- Type
- Privately Held
- Founded
- 2011
- Specialties
- Executive & Team Development, Commercialization Strategy, Product Development, Insights & Research, New Market Evaluation, Scientific & Competitive Landscape Assessment, Brand Development & Evolution, Strategy, Positioning, & Optimization, Strategic Communications, Digital Transformation, Forecast Modeling & Assumption Development, Financial Planning & NPV Analysis, Financial Analysis Supporting Go / No Go (LCM, etc.), New Customer & Market Opportunity (Quant / Financial Implications), Target Product Profile (TPP), Target Label, Clinical Development Plan, Performance Optimization, Story, Data, & Evidence Optimization, Competitive Analysis & Planning, Marketing & Advertising, and Medical Affairs
Locations
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Primary
12555 High Bluff Drive
Suite 300
San Diego, CA 92130, US
Employees at Vault Bioventures
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Joachim Osther
Sr. Vice President at Vault Bioventures; Freelance Writer
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Sherry Barnes
Executive Assistant to the President and CEO
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Joe Young
Entrepreneur with a Passion for Healthcare Innovation ★ President & CEO at Vault Bioventures, Inc.
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Christopher Vohnout
Chief Financial Officer at Vault Bioventures, Inc.
Updates
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Pfizer and Flagship Pioneering are expanding their collaboration, now including Quotient to explore somatic mutations for new heart and kidney disease treatments. With up to $700M on the line per successful drug, this partnership could transform cardiometabolic care. 💡 Insight - Using somatic genomics to discover new drug targets could significantly impact cardiovascular and renal therapies. ❓ What other diseases could this approach tackle next? #PharmaInnovation #DrugDiscovery #Healthcare #Biotech #CardiovascularHealth
After obesity, Pfizer and Flagship pick 2 more targets for multibillion-dollar partnership
fiercebiotech.com
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Labor Day is a tribute to the hard work, dedication, and resilience of workers across all industries. At Vault Bioventures, we take this day to appreciate our incredible team and all those who contribute to advancing healthcare innovation. Wishing everyone a relaxing and well-deserved Labor Day! #LaborDay #ThankYouTeam #HealthcareInnovation
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The healthcare sector is buzzing with the promise of AI, but as payers look to leverage AI for modernization, understanding its true potential and limitations is crucial. 💡 Where AI Works - AI tools like generative AI copilots can effectively handle data migration, automate code writing, and streamline approval processes, freeing up resources to focus on strategic tasks. ⚠️ Where AI Falls Short - AI should never replace human oversight in ethical decisions or rare condition management. Misuse can lead to disastrous outcomes and erode trust with both customers and partners. 🤔 Key Takeaway - AI isn't a magic bullet. Success requires careful implementation, continuous monitoring, and a thoughtful strategy to truly enhance payer operations. #HealthcareAI #PayerModernization #DigitalTransformation #AIinHealthcare #HealthcareInnovation #DataAnalytics
The Truth About AI and Healthcare Payer Modernization - MedCity News
https://medcitynews.com
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AI Continues to Excite Healthcare Leaders in 2024 Key Takeaways from the Latest UPMC & KLAS Research Survey: ▶ AI Tops the List - For the fourth year running, AI is the most exciting emerging technology for healthcare executives, with 85% citing its potential to revolutionize administration, clinical care, and operations. ▶ Rapid Improvements - AI, especially large language models and generative AI, shows significant progress. Leaders are leveraging these advancements to reduce clinician burnout, automate tasks, and enhance patient satisfaction. ▶ Solving Core Challenges - From patient care to access and provider burnout, executives see AI and technologies like ambient speech as key to overcoming these hurdles and improving efficiency and profit margins. #HealthcareInnovation #AIinHealthcare #PatientCare #HealthcareLeadership #UPMC
C-suite surveyors: AI ‘continues to excite healthcare leaders’
aiin.healthcare
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The integration of AI-driven tools is revolutionizing healthcare, with Pfizer, Reliance Rx Specialty Pharmacy, and Elation Health leading the way. Reducing Costs ⤵ Reliance Rx joins Waltz Connect to streamline specialty pharmacy services, aiming to save over $5,200 per clinical interaction. Enhancing EHRs ⤵ Elation Health’s Note Assist simplifies documentation with AI-powered note-taking, boosting efficiency and improving patient-doctor connections. Easier Access ⤵ Pfizer's PfizerForAll platform connects patients with care resources and medications, simplifying the healthcare experience. #AIinHealthcare #SpecialtyPharma #PrimaryCare #DigitalHealth #HealthcareAccess #Pfizer #ElationHealth #RelianceRx
Vendor Notebook: Specialty pharma, primary care AI to speed care
healthcareitnews.com
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Cigna Healthcare to Remove #Humira from Preferred Drug Lists in 2025 Key Points ⤵ ▶ Shift to Biosimilars - Cigna’s decision to remove AbbVie’s Humira from some reimbursement lists and recommend more affordable biosimilars like Boehringer Ingelheim's Cyltezo, Teva’s Simlandi, and others, starting in 2025. ▶ Industry Trend - Following in the footsteps of CVS Health's Caremark unit, this marks another major move in favor of biosimilars over high-cost drugs. ▶ Impact on Market - AbbVie, despite its stronghold on the market, is expected to lose share as more PBMs opt for biosimilar alternatives. ▶ Regulatory Scrutiny - Pharmacy benefit managers are under increased scrutiny for their role in drug pricing, with claims they help lower costs, while critics argue they contribute to high prices. ▶ Humira’s Legacy - Once the top-selling prescription drug globally with peak sales of $21.2 billion in 2022, Humira’s market dynamics are rapidly changing. As the healthcare industry pushes for more cost-effective solutions, this decision marks a significant step toward making treatment more affordable for patients. #Healthcare #Biosimilars #PharmacyBenefits #Cigna #DrugPricing
Cigna to remove AbbVie's Humira from some drug reimbursement lists next year
reuters.com
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Prostate Cancer Research (PCR) has launched the Proactive For Your Prostate campaign, urging the UK government to implement a national screening programme for prostate cancer. With a petition already signed by over 135,000 people, this movement aims to address health inequities and improve survival rates for men across the nation. 💡 Insight ⤵ Current screening practices leave many at-risk men undiagnosed, relying on individual awareness and proactivity. The new campaign calls for recent advances in prostate cancer diagnosis to be utilized at a national level, ensuring early detection and better outcomes for all men, regardless of their location. ❓ Questions to Consider ⤵ Will the government respond to the call for a national screening programme? How can we further raise awareness about the importance of early detection and equitable healthcare access for prostate cancer? #ProactiveForYourProstate #ProstateCancerAwareness #HealthEquity #EarlyDetection #MensHealth #CancerScreening #HealthcareAdvocacy #PCR #PublicHealth #UKHealthCampaign
National campaign launches to end prostate cancer postcode lottery
https://pharmatimes.com
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🗞️ This week’s Vault Healthcare Industry Weekly Wrap-Up delivers significant industry developments. In biotech and pharma, Eli Lilly and Company's move to offer discounted direct access to #Zepbound via #LillyDirect highlights a major push to enhance affordability and accessibility in the weight-loss market. Meanwhile, Amgen has made strides with #Otezla, the first oral therapy approved for severe plaque psoriasis in children aged 6-17, a game-changer for pediatric dermatology. On the tech front, Pfizer's launch of #PfizerForAll marks a bold entry into the direct-to-consumer telehealth space, simplifying healthcare access for common conditions. In business and market news, AstraZeneca is reinforcing its commitment to biologics with a $135 million investment in its Swedish facility, reflecting a broader trend of biotech companies investing in localized R&D and manufacturing capabilities. Similarly, Bayer's partnership with NextRNA Therapeutics to develop RNA-targeting #cancer therapies signals an ambitious expansion into precision oncology. On the research front, The National Institutes of Health's $270 million anti-overdose program led by Native Americans represents a significant investment in addressing the opioid crisis in indigenous communities, showcasing the importance of culturally informed healthcare initiatives. These developments signal pivotal shifts across healthcare sectors—click to explore the full stories and more! 👇👇
Healthcare Industry News Weekly Wrap-Up: August 29, 2024
https://vaultbio.com
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🚀 Piramidal Secures $6M to Revolutionize Brain Condition Diagnostics with #AI Highlights ⤵ ▶ Innovative AI Model - Piramidal’s proprietary model uses advanced machine learning and EEG analysis to streamline brain condition diagnostics, starting with epilepsy. ▶ Speed & Accuracy - The model reduces review time and minimizes error margins, aiming to make brainwave analysis faster and more reliable. ▶ Strategic Funding - Backed by Y Combinator, Adverb Ventures, and other high-profile investors, this $6M seed funding will accelerate the development and market launch of Piramidal’s AI. ▶ Broad Applications - Future plans include expanding into neurology diagnosis, drug discovery, remote monitoring, and real-time brain health tracking. #AIinHealthcare #BrainHealth #Neurology #HealthcareInnovation #Piramidal