Anomaly Insights and Inova Health System Announce Collaboration to Analyze Payer Behavior and Improve Payment Outcomes

Brings artificial intelligence to Inova's revenue cycle and managed care teams to analyze payment patterns and support revenue management

NEW YORK--(BUSINESS WIRE)--Anomaly Insights today announced a collaboration with Inova Health to provide Inova’s revenue cycle and managed care teams with additional data and analytics to evaluate payer behavior and payment outcomes. In the first 90 days, Inova identified $10.4 million in recovered revenue opportunities, with an estimated $3.8 million in ongoing monthly revenue impact, value Inova is reinvesting directly into patient care and the communities it serves.

Payers ultimately determine coverage and payment decisions, including which services are approved, delayed or require additional review. These decisions directly harm patients through delayed or canceled care and anxiety about paying for treatment, creating confusion and ambiguity. In cases where payers retroactively retract payment for services that have been provided, this drains resources that health systems like Inova could otherwise invest in care. The artificial intelligence and data support Anomaly provides helps bring clarity and predictability to payment patterns, enabling teams to better understand trends and make more informed decisions.

Anomaly and Inova have leveraged these tools to promote greater payer accountability and transparency around contracted terms, rules, and policies with clear, comprehensive data and evidence. This is part of a broader strategy at Inova to enable AI directly into its revenue cycle and managed care operations, freeing its teams to spend less time on tedious manual dispute work and more time architecting productive relationships with payers, resulting in more clarity and certainty for patients. This approach positions Inova among a small group of health systems moving AI beyond pilot programs and into the center of how they manage more positive payer relationships.

"Anomaly has provided our teams with the data and insights we need to better understand payment patterns and identify opportunities to improve our revenue operations,” said Erin Hodson, MSN, Vice President of Revenue Cycle at Inova Health System. "Every dollar we recover through this work is a dollar we can reinvest in the patients and communities we serve. By bringing greater visibility and transparency to complex payment processes, we can make more informed decisions and continue strengthening our approach to revenue management."

"Inova wanted proof, not promises, and that is what this partnership was built to deliver,” said Mike Desjadon, CEO of Anomaly Insights. “Across the industry we’re increasingly seeing a lack of data as the barrier to more productive relationships between payer and provider with providers always at the short end of the stick. We help eliminate that barrier, showing Inova exactly where payers deviate from contracts and policies both sides agreed to, and allow them the freedom to intervene appropriately - whether it be a workflow automation or a better negotiation. Inova is willing to reimagine the status quo and build towards a better future for their patients. We’re thrilled to be part of it and support them.”

About Anomaly
Anomaly is a leading data science and engineering company that builds AI payment solutions for health systems. Anomaly enables customers to recover revenue, negotiate contracts, change payer behavior, and automate complex workflows. Utilizing artificial intelligence, machine learning, and advanced statistics, Anomaly builds the digital infrastructure that allows customers to uncover how payments work in their specific market. Anomaly’s platform analyzes billions of transactions and compares them against contracts, payer policies, and adjudication decisions.

Learn more at findanomaly.com.