Concuity

About Concuity

Concuity, established in 2000, operates as a specialized provider of revenue cycle management (RCM) solutions tailored for the healthcare industry. The firm was founded by a group of healthcare industry visionaries to address inefficiencies in the revenue processes of healthcare organizations. Initially known as eHealthContracts, the company has undergone several strategic acquisitions, shaping its trajectory and capabilities. In December 2006, Trintech Group acquired Concuity for a total consideration of up to $8.25 million. Subsequently, in March 2010, The Advisory Board Company acquired Concuity from Trintech for $34.5 million, integrating its contract management software into a broader portfolio of services for the healthcare sector.

The company's business model centers on delivering a combination of web-based software, offered through an application service provider (ASP) model, and professional services to hospitals and health systems. This dual approach helps clients optimize contract profitability, ensure payer compliance, manage denials, and recover underpayments. Revenue is generated by providing these targeted revenue recovery solutions, which analyze contracts and accounts to identify and rectify underpayments, following up with payers until the correct contractual payment is received.

Concuity's flagship product is the ClearContracts™ suite, a web-based software that provides healthcare providers with the tools to manage their managed care contracts and revenue recovery objectives. The platform is designed to identify and eliminate systemic issues that lead to revenue leakage. Its features include advanced calculation engine modeling to help providers negotiate future contracts more effectively by reflecting proposed reimbursements. A key component, EOB PRO, automates the conversion of paper-based Explanation of Benefits (EOBs) into HIPAA standard 835 formats, which streamlines data entry and enhances the ability to manage denials and underpayments. This allows healthcare organizations to consolidate remittances into a single data stream, providing greater control and visibility over transaction processes. By ensuring accurate claims reimbursement and improving payment collection workflows, Concuity aims to deliver a significant return on investment and sustainable improvements in profitability for its clients, which have included large hospital systems like Providence Health System and Sutter Health.