Download PDF version +

Customer Profile

Cleveland Clinic, located in Cleveland, Ohio, is a multi-specialty academic medical center that integrates clinical and hospital care with research and education. Today, Cleveland Clinic is ranked among America’s Top Hospitals by U.S. News & World Report.

Customer Case Description

As a top American hospital, Cleveland Clinic serves hundreds of thousands of patients and works with more than 1,500 doctors. This equates to a large number of claims that may be denied by insurance companies for a wide variety of reasons. The Clinic’s staff needed a way to quickly identify problems with insurance submissions because every claim denied corresponds to a temporary loss of revenue.

Cleveland Clinic has a powerful, homegrown Denial Database and Denial Database Application in place for managing, storing, and working denial information. But the massive amount of data—more than 200 relationships in SQL tables—make conducting interactive analysis nearly impossible. Monthly reports are useful but there was no easy way to connect to live source data to find specific claims, and to quickly resolve large-scale claim issues. Also, because each department used the database for different reasons, the Clinic needed an application that would create easy-to-understand reports for a large number of its employees—not just the IT staff or business intelligence specialists.

The Solution

In order to proactively and efficiently handle denials, Cleveland Clinic selected Tableau Software for visual data analysis, trending and reporting. Visualization allows the Clinic to identify trends among large groups of denials, which is knowledge that wouldn’t be gained by analyzing each denial individually. As a result, Cleveland Clinic can identify potential denial issues before they become a problem and uncover areas for improvement for each individual department. This, in turn, expedites the claims approval cycle and saves time and money for the organization.

“The biggest benefit of Tableau is that we can now do trending analysis and understand issues earlier in their lifecycle,” said Josh Berman, Senior Manager, Electronic Claims and Denials. “Before we started using Tableau, we found out about issues because they blew up on our monthly reports, which for an organization our size means significant costs and lost opportunities. Now, with Tableau, we can still uncover individual denial issues—we’re just faster at it—and we can find the top five reasons overall for denials. By identifying the source issues, we can then proactively find solutions and reap the benefits across dozens and dozens of claims. We weren’t able to do that when we were just analyzing claims on a case-by-case basis.”