/value-lab
From value case to build plan.
Run proven value cases on your data. Get the ROI, the roadmap, and the blueprint to build.
01 · Library
350+ cases, ready on day one.
The cases cover every part of a payer’s business. Each one is a ready-made way to save money or earn revenue. To add your own, describe it in a sentence.
CaseOne of 375 cases
Modifier 25 misuse
MedEx · Claims and payment
Add a caseDescribe it in a sentence
Demo data
02 · Readiness
Agents run every case on your data.
Agents run each case on the data you connected. They find out if the case can run, and they size its value in dollars. When data is missing, they name it and suggest a connection to get it.
Value Lab agentRan at 2:00 AM · read-only
- Read claim lines, claim headers, and providers
- Ran 3 queries on 186,420 claim lines
- Found 6,320 visits from 41 providers
Value$512,400 in payments to review
Connections
Nothing to connectAll 5 needs found
Demo data
03 · Connect
See what to connect next.
Value Lab lists the sources you have not connected yet. Each one shows how many cases it would unlock and what they are worth. Your team approves each connection before an agent uses it.
Connect next
Demo data
04 · Prioritize
Start with the quick wins.
Each case is placed by its yearly value and the effort to run it. Quick wins sit in one corner: high value, low effort. Pick medical cost, operating cost, or revenue to see which cases to start with.
ReadyGapsBlockedSize shows yearly value
Start hereDemo data
Quick wins first, then the most value for the effort
10 quick wins in this view, worth $6M a year
05 · Run
Run a case in chat. Get the business case.
Open a chat with the case attached and ask it to run on your data. The answer comes back with the rows behind it. The case fills in its business case: value, cost, payback, and return.
Modifier 25 misuseCase attached · MedEx · Claims and payment
Ready5/5You
Run this case on last year’s paid claims and project the value.
ContextBase
41 providers billed modifier 25 on same-day procedures at more than twice their specialty’s rate. Last year that came to 6,320 visits and $512,400 in separate E/M payments.
| Provider | Specialty | Modifier 25 rate | Peers |
|---|---|---|---|
| NPI …4417 | Dermatology | 61% | 24% |
| NPI …2290 | Orthopedics | 48% | 19% |
| NPI …8051 | Family medicine | 39% | 15% |
3 queries · 186,420 claim lines · 4 checks met
Ask about this case
06 · Plan
Plan the build, with a blueprint.
Put cases on the roadmap, set the order, and give each one an owner. Value Lab can suggest an order, and you can undo it. Each case gets a blueprint: the data, the logic, the output, and who owns each part.
Roadmap
- Modifier 25 misusePayment integrity lead
- Exact duplicate claim linesClaims operations
- Encounters not submittedRisk adjustment lead
- Outpatient surgery moved to hospitalsCost of care lead
Blueprint · Modifier 25 misuseAbout 3 weeks
Demo data
07 · Hand off
Hand off a case, with all its work.
Everything on a case is saved with it, so nothing is lost when someone leaves. Hand it to anyone with access to its data. They see the full history and start where you left off. Export any case as a one-page PDF or a Markdown summary.
Hand offModifier 25 misuse
Goes with it
- Chats
- 3, with every query and answer
- Findings
- 2, each tied to its rows
- Artifacts
- A deck, a dashboard, and a file
- History
- 41 events since the first run
Hand to
NoteProviders 1 to 10 reviewed. Start with NPI …2290.
Handed to the coding review lead · Oct 6, 4:12 PM · logged
Demo data
See which cases your data can run.
Bring the systems your team runs. We connect them and run every case, so your first project is one your data supports.