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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.
Error Trend Analysis

Harness the power of our Error Trend Analysis solution to unearth invaluable insights into error patterns and trends within your operations. Through the utilization of sophisticated algorithms, our system adeptly detects and analyzes various error types, enabling you to proactively identify the underlying causes behind reduced accuracy. This proactive approach significantly enhances the overall process quality by facilitating the early identification of potential issues. This can encompass new guidelines, resources, or the need for training. By addressing these concerns before they affect SLAs, you can uphold operational excellence and maintain your commitment to delivering exceptional quality.

Strategic Insights:

Introducing Error Trend Analysis as a potent tool unveiling strategic insights from operational error patterns. Sophisticated algorithms detect diverse error types, revealing root causes behind accuracy reductions and providing an informed perspective on operational challenges.

Proactive Quality Enhancement:

Highlighting Error Trend Analysis’ proactive role in elevating process quality. Early trend and error pattern identification allows organizations to refine their processes. This can involve updating guidelines, providing additional training, or implementing new tools and technologies to mitigate errors.

SLA Adherence:

Proactively addressing errors helps ensure that service level agreements are consistently met or exceeded. This contributes to efficiency and customer satisfaction.

Capacity Planning

Achieving the ideal work audit percentage and aligning resource capacity for audits becomes a seamless process with InsightPRO. Through the utilization of our AI/ML-based capacity planning engine, receive valuable suggestions regarding the appropriate audit percentage and rules. This innovative feature empowers you to optimize resource allocation, eradicate bottlenecks, and make well-timed decisions, all in pursuit of ensuring continuous quality and efficient capacity planning.

Efficient Audit Alignment:

By utilizing AI and machine learning algorithms, the audit engine can analyze vast amounts of historical data and current workload patterns. This data-driven approach provides precise recommendations for the appropriate audit percentage and rules, ensuring decisions are based on empirical evidence.

Resource Optimization:

The engine helps processes align their resource capacity with audit requirements effectively. This optimization can lead to a reduction in resource underutilization or overallocation, resulting in cost savings and improved operational efficiency.

Timely Decision-Making:

InsightPRO offers actionable insights, and empowers managers to make informed decisions about resource allocation, audit percentage, and audit rules. This not only improves efficiency and reduces costs but also supports the pursuit of continuous quality and capacity planning excellence in audit processes.

Inventory Management

Efficient inventory management highlights an unwavering commitment to quality. Effective inventory management comprises critical components, including accurate inventory tracking to facilitate automated Inventory replenishment adhering to defined rules and capacity. The inventory management techniques employed in Quality include the push technique and the pull technique.

Essential Components:

The heart of effective InsightPro inventory management lies in core elements. This includes precise tracking of inventory, a cornerstone enabling automated replenishment adhering to predetermined rules and capacity constraints. Such precision guarantees optimal inventory levels, maintaining operational efficiency.

Strategic Techniques:

Quality-Driven Inventory Management Techniques: Quality management often employs two primary inventory management techniques: the push technique and the pull technique. Push Technique wherein the inventory is replenished based on forecasts and production schedules. This approach is proactive and ensures that records for audit are readily available. However, it can sometimes lead to overproduction or excess inventory. Pull Technique which is often associated with just-in-time (JIT) inventory management, replenishes inventory only when there is actual demand. This approach minimizes excess inventory.

Defined Rules and Capacity:

Processes establish specific rules and criteria for inventory management. These rules can include types of claims to be audited, Inventory Replenishment, and lead times. Capacity considerations consider factors like wastage, audit capacity, and demand fluctuations. Adhering to these defined rules and capacity constraints ensures that inventory is managed efficiently and aligns with quality goals.

Sampling

Sampling plays a vital role in the type of work being audited for quality. It elevates quality assurance procedures by implementing an automated system offering diverse sampling methods, including random and stratified sampling techniques. This system enhances the precision and reliability of quality checks within the operational framework, contributing to improved accuracy and compliance.

Refined Operational Efficiency:

Integrating rule-based automated sampling focusing on factors such as the line of business (LOB), claim type, tenure, dollar amounts, etc. enhances operational frameworks. Improved accuracy and compliance contribute to enhanced efficiency. Reliable data forms the basis for better decision-making, reinforcing operational excellence.

Versatile Sampling Techniques:

The system employs various sampling techniques, including random and stratified methods recommended by managers and AI, to ensure a comprehensive approach. This diversity empowers organizations to understand operational quality holistically through representative samples.

Precision in Quality Assurance:

Dashboards that depict the effectiveness of sampling within InsightPro are instrumental in streamlining the process of identifying efficient versus non-efficient sampling rules and techniques. These dashboards provide a visual representation of sampling outcomes, allowing quality managers and teams to analyze the recommendations made by the system and strike a balance between AI-driven sampling rules and manager-suggested sampling rules. This dynamic approach enables organizations to obtain targeted and optimal sampling data.