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CLAIMS FEATURES

Work Distribution

Efficiently assigning work based on roles and resources.

Inventory Management

Real-time tracking, aging analysis, and capacity utilization.

Auto Triaging/Deep Learning

Deep learning to categorize and prioritizing incoming claims.

Target Management

Data insights enable precise goal-setting.

Optimized Workflow

Reducing manual effort and minimizing the risk of inaccuracies.

Production Forecasting

Informed decision-making and resource utilization optimization.

Production Planning & Control

Precise capacity planning for seamless resource utilization.
 
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QA FEATURES  

Sampling

Enhances the precision and reliability of quality checks within the operational framework.

Inventory Management

Tracking for automated inventory replenishment according to defined rules and capacity.

Work Distribution

Using AI/ML to allocate samples to analyze experience, line of business, costs, and other parameters.

Criteria-based Audit

Seamlessly evaluation compliance with predetermined criteria for different types of samples.

Audit the Auditor

A proprietary process that conducts multiple levels of audits at each stage.

Real-time Error Feedback

Enhances responses with automatic notifications and dynamic interactions that amplify audit precision.
 
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CSR FEATURES  

Work Summary

Summary of the previous work day so Customer Service can start off strong with an overview of their performance and responsibilities.

Call Kick-off

Structured and efficient way for Customer Service to initiate and document calls with members and providers.

HIPAA Verification

Ensuring that health-related information is accessed and shared only with authorized individuals.

Member Landing Page

Member demographic information, eligibility/claims/billing information and call history information.

Call Reason

Call documentation and categorization to help manage inquiries based on the nature of each call.

Quick Reference/Actions/Views

Real-time access to information and streamlined communications across departments.
 
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A Workforce Analytics Platform Built Specifically for Payers

InsightPro is the first-of-its-kind AI/ML enabled workforce management platform that helps payers improve operational efficiencies.

A platform built exclusively for payers that integrates claims processing, quality assurance, training and a robust contact center all powered by AI/ML.

How It Works

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Unlock workforce management excellence with InsightPro's innovative analytics platform for payers of all sizes.

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ANTICIPATE WHAT’S AHEAD

Reduce the Cost of Operations and Build a Modern Workforce

With our advanced AI-driven analytics, resource allocation becomes a breeze as you gain valuable insights and predictive capabilities. OR leverage the full potential of our state-of-the-art technology to seamlessly navigate the ever-changing dynamics of your workforce.

Claims

Our AI solution can resolve up to 80% of your claims processing problems and inquiries.

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Quality Assurance

Capacity planning, sampling and work allocations target your issues and ensure efficiency.

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Contact Center

Our AI-enhanced call center solution dramatically increases First Call Resolution (FCR).

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Smart Tech = Smart Teams

InsightPro is the first-of-its-kind AI/ML enabled workforce management tool that empowers leaders, fosters team collaboration, and revolutionizes payer operations with its cutting-edge features and advanced capabilities.

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BACKED BY EXPERIENCE AND BUILT FOR NOW

Over 20 years of experience as a trusted business management services partner.

InsightPro is developed and maintained by MDI NetworX. Our products are a strategic investment in operational efficiency for payers.

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Team Productivity

Workforce Planning

Real-time Monitoring

Workforce Optimization

U.S. Based and Globally Backed

Deep expertise in healthcare working in partnership with leading payers, TPAs, and health systems.

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Discover how InsightPro can help you manage your workforce with a first-of-its-kind analytics platform developed for payers of every size.

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