InsightPro Demo
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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WORK EFFICIENCY

Foster Engagement, Creativity and Efficiency by Tracking and Enhancing Work Habits

Home » Capabilities » Work Efficiency

Work Efficiency

Optimize team productivity by analyzing total work hours versus focused, productive time. With insight into work efficiency, engagement, creativity, and work habits can all be greatly increased.

  • Evaluate overall work hours against productive hours with InsightPro, facilitating goal-setting and week-over-week comparisons to gain valuable insights into team behaviors.
  • Monitor productivity and efficiency to gauge employee engagement, ensuring the availability of focused time for creative thinking, problem-solving, and professional growth.
  • Analyze productive and focused time to identify distraction reduction areas and cultivate better focus habits, enhancing overall efficiency and task engagement within the healthcare service environment.
Block Claims-Claims

Block Claims-Claims

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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

Check Run & Stop Loss-Claims

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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

Real-time Notifications-Claims

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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.