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An integrated workforce analytics platform powered by AI and machine learning.
Claims Management Solutions
Reduce denials, improve first-pass rates and cut admin burden.
Quality Assurance Solutions
Integrate sampling, capacity planning, comprehensive auditing, and rebuttals.

Contact Center
Solutions

Improve First Call Resolution with AI-enhanced integration.

How It Works

Integration

Privacy & Security

Proven it will
pay for itself in
the first year.
Our integrated workspaces are designed to help you get more done, faster.
Claims Management Features
Enhance productivity, AI-powered distribution, and production planning.
Quality Assurance Features
Improve First Call Resolution, call history and cross-department integration.

Contact Center
Features

Robust error feedback, rebuttal workflow, and error trend analysis.
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Activity Tracker
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Optimized Workflow
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Audit Trail
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Block User
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Block Claims
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Check Run and Stop Loss
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User Management
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Training Need Analysis
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KPI-based Dashboards
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Real-time Query Resolution
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Real-time Notifications
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Idle Time and Break Tracking
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Production Planning & Control
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Production Forecasting
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Target Management
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Auto Triaging
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Inventory Management
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Work Distribution
InsightPro Activity Tracker

InsightPro helps you elevate resource management with an integrated activity tracker, offering supervisors and managers unprecedented insights into team performance and resource allocation.

This dynamic tool centralizes resource information, eliminating the need to gather data from multiple sources to facilitate quicker decision-making and optimized outcomes.

Users have access to individual and team performances based on a comprehensive overview of tasks performed. This enables data-driven performance improvement strategies, paving the way for greater efficiency.

InsightPro Activity Tracker

InsightPro conducts a systematic analysis of your current workflow to identify bottlenecks, redundancies, and areas for improvement.

Our tool then automates manual and error-prone tasks and establishes KPIs to quantify the workflow’s effectiveness. This seamless integration of enhancements fosters continual improvement through user input and vigilant monitoring, ensuring sustained adaptability amid evolving circumstances in the healthcare industry.

InsightPro Activity Tracker

InsightPro comprehensively tracks, records, and reports every facet associated with a specific workflow or business process.

Users get insights into participants, actions, timestamps, locations, and transaction methods in order to ensure transparency and accountability. This multifaceted tool also verifies task execution adherence and supports regulatory audits to validate compliance with established standards. For new employees, audit trails visually demonstrate the correct execution of processes, aiding training by showcasing real-world task execution.

InsightPro enhances error control and accountability by temporarily blocking users and restricting claim processing when predefined error thresholds are exceeded.

Users can fine-tune this threshold to align with specific quality control standards, ensuring that claims with excessive errors are intercepted for rectification before further processing. This ensures data accuracy, quality, and proactive error management, ultimately contributing to smoother operations and enhanced claim accuracy.

InsightPro gives you the unique ability to retrieve and block claims linked to similar providers, CPT Codes, and more.

Users can handle similar claims in a batch rather than individually which optimizes the process flow and minimizes the time spent on repetitive tasks.

When you apply consistent evaluations and checks to related claims it ensures uniformity and reduces errors that could arise from disjointed processing. This leads to increased productivity and higher accuracy rate/better quality.

InsightPro enhances your processing efficiencies with this innovative, dual-action feature.

The Stop Loss functionality prioritizes work distribution to examiners while the Check Run holds the define groups for distribution and releases the same on completion of check run. Together, these features optimize operations and ensure effective work allocation.

Now examiners can focus on high-priority tasks while processes, maximizing process efficiency and ultimately contributing to streamlined workflows.

InsightPro empowers managers and supervisors with streamlined control to elevate administrative efficiency.

This robust tool eliminates the need for change requests and manual adjustments by providing configurable user and group settings, allowing for seamless group establishment, user assignment, and precise access privilege control.

Users gain effortless configuration control, simplified group management, and hassle-free user assignment, ensuring that team structures and access permissions remain aligned with evolving operational requirements. This leads to increased security and efficiency.

InsightPro leverages machine learning and advanced outlier detection to pinpoint resources requiring additional training by analyzing performance, quality, and productivity data.

Our dynamic ramp-up plans adapt weekly or monthly, enhancing training effectiveness with ongoing benchmark updates.

Using these in-depth analytics to assess trainee performance pre and post-training, users are provided with valuable insights for data-driven evaluation of training program efficacy.

InsightPro leverages the power of integrated dashboards and analytics to give users real-time access to process insights, helping to identify and address areas requiring attention swiftly.

These actionable dashboards elevate operational excellence by delivering heightened visibility and control to enhance operations management, enabling proactive decision-making, optimizing performance and adhering to SLA standards.

Executive Dashboards: Drive process efficiency, streamline operations, identify trends, and enhance overall performance through the insightful assessment of inventory, production, productivity, and accuracy reports.

Supervisor Dashboards: Pinpoint over or under-utilized individuals and teams in order to make adjustments for balanced workloads, address staffing concerns, and optimize resources, leading to enhanced retention rates.

Personal Examiner Dashboards: Examine personal performance with insights pinpointing productivity and focus influencers that identify supportive and hindering aspects of practical work. Act upon suggestions for improvement in quality and accuracy of work.

Manager Insights (Team Productivity) Dashboards: Acquire insights into monthly productivity fluctuations among teams across diverse locations or processes, enabling optimized resource allocation and enhanced performance management.

InsightPro AI Assistant Efficiency Dashboards: Measuring the effectiveness of AI expertise in answering queries accurately and finalizing the queries sent to SMEs for resolution.

Process KPI Dashboards: Display health of the process, and highlights outliers related to the KPIs – TAT, productivity, accuracy, volume, etc. This streamlines intricate decisions through prompt data analysis, effortlessly allowing users to oversee and improve process health with ease, strengthen forecasting and process management capabilities.

Productivity Dashboards: Get insights on the productivity trend for all the resources. This helps you manage the workload of teams, identifying the training and ramp up plan needs of individuals and teams.

Our Virtual InsightPro Assistant elevates your support capabilities through the use of real-time AI-powered solutions.

This dynamic assistant combines natural language-based AI with Machine Learning to provide prompt answers, replicating human conversational patterns to engage users naturally.

By pairing its extensive knowledge base with a collaborative approach with human subject matter experts (SMEs) when needed, the Virtual InsightPro Assistant provides optimal query resolution. This ensures the delivery accurate and efficient user interactions.

InsightPro is revolutionizing operations through real-time notifications and automated alerts backed by advanced machine learning techniques and impactful indicators.

KPI-based thresholds are set in place to notify of any potential errors, prompting immediate action and ensuring superior data quality.

This transformative approach enhances visibility and control for users, leading to effective operations management that drives lasting success.

InsightPro leverages meticulous time allocation monitoring to provide insights and recommendations into your workforce’s time management.

This tool allows users to effortlessly categorize tasks as productive or non-productive activities, monitoring time disruptions and resource utilization. Based on these findings, tailor-made suggestions for refining time management practices are provided in order to enhance efficiency and achieve organizational success through improved productivity.

InsightPro transforms production planning and control by utilizing data-driven strategies to optimize operations, prevent SLA and regulatory violations, and enhance process efficiency.

It employs accurate forecasting, streamlined work distribution, workflow automation, and meticulous capacity planning to ensure seamless resource utilization and elevate delivery outcomes.

By assessing processes through various KPI parameters and ranking them based on importance, users can make timely delivery decisions based on recommendations and forecasts for resource, volume, and time impacts. It also automates work distribution tasks based on process requirements and resource capabilities, tracking resource skillsets and uncovering capacity utilization for efficient demand fulfillment.

InsightPro offers real-time insights, forecasting, and streamlined dashboards for enhanced production planning and informed decision-making.

This tool tracks key metrics like pending volume, target completion time, and resource utilization to help teams and managers meet their demands and clear backlogs within their service level agreements (SLAs). This approach ensures the prompt handling of workloads and prevents the potential costs linked to SLA non-compliance and regulatory commitments.

InsightPro optimizes productivity goals with a holistic approach to target allocation.

With this tool, users are ensured collaborative target alignment with business objectives while also upholding ethical standards.

Our data-driven precision provides customized efficiency and tailored productivity goals to optimize resource-specific targets and enhance operational effectiveness.

InsightPro integrates a deep learning-driven auto triaging process that streamlines received inventory and the prioritization of incoming tasks.

When deployed within regulatory frameworks, users can expect to experience optimized efficiency while still maintaining compliance and accuracy. Image classification analyzes photos with AI-based Deep Learning models that identify and recognize various criteria—from image contents to the time of day.

Below is a tailored implementation strategy with the following healthcare context:

Pre-Processing (Prepare): All data undergoes preparation to improve its quality and suitability. The pre-processing step eliminates undesirable elements and enhances essential aspects of images, making them more compatible with AI processing. Tasks include: duplication removal, irrelevant data trim, filter of outliers, the identification of missing data, and the correction of structural errors.

Object Detection (Locating): This stage involves the crucial task of pinpointing objects within images, achieved through image segmentation and determining object locations.

Object Recognition and Training (Labeling): Deep Learning algorithms delve into images in this phase, extracting patterns and distinctive attributes associated with specific labels.

Object Classification (Applied): This marks the peak of the process. At this stage, you’ve constructed an AI model capable of categorizing images based on various criteria and patterns learned from the training data.

Connecting Workflow (Integration): You are now ready to integrate your image-classifying AI model into an AI workflow. This connection involves specifying the input source, where new data is obtained, and the corresponding output, which determines the actions taken once the data is classified.

Feedback Loop (Retraining): To sustain effectiveness and relevance over time, the last step is to create a cyclical feedback loop that regularly collects operational process insights and incorporates them into the model’s learning process.

InsightPro optimizes inventory management using real-time tracking, aging analysis, and capacity utilization monitoring to enhance resource efficiency, improve turnaround times and streamline operations.

Inventory gets automatically tracked across its entire lifestyle, spanning from creation to disposition. Managers can then categorize ongoing tasks into age brackets like 15+ or 30+ days, identifying potential roadblocks, facilitating reallocation of volume, and ensuring tasks remain on track. These insights uncover performance patterns and trends, aiding users with better strategic decision-making capabilities.

InsightPro encompasses two work distribution approaches to enhance flexibility and efficiency, catering to various work types and optimizing resource utilization.

After records/documents are ingested via API or Service into the Queue(s), there are two basic ways of distributing them:

Manual Distribution Based on Resource: Resources pick what they want to work on from any assigned work Queues. There are two variations, depending on whether the work is assigned to the OHB (Over Head Bin – a repository of documents/records) or to personal work Queues.

Automation Distribution Based on Rules: The work in the Queues can be allocated and intelligently assigned based on predefined rules using atomic distribution. Strategically group work based on LOB, Claim Type, Aging, TAT, Priority, Pending Inventory, and Errors – then assign work based on the user roles, expertise, and permissions of the resource(s).