Reduce errors and increase accountability by restricting claim processing when errors exceed a predefined threshold.
Block Claims-Claims
Minimize the time spent on repetitive tasks and reduce processing time by grouping claims under similar providers and CPT codes rather than having to manage them individually.
Check Run & Stop Loss-Claims
The system distributes stop loss-related claims so that critical issues are promptly addressed, minimizing potential losses and operational disruptions to ensure timely task handling and strategic resource allocation.
Real-time Notifications-Claims
Automatic alerts for potential errors and KPI thresholds to protect data quality and ensure timely corrections, all powered by AI/ML that fosters a culture of continuous improvement and efficiency standards.
Auto Triaging/Deep Learning-Claims
A customized categorization model using AI and deep learning to triage and streamline document management workflows that are unique to the demands and variability of healthcare data.