An integrated workforce platform powered by AI and machine learning. See all solutions.

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 solutions are designed to help you get more done. See all features.

Claims Management Features
Enhance productivity, AI-powered distribution, and production planning.
Quality Assurance Features
Robust error feedback, rebuttal workflow, and error trend analysis.

Contact Center
Features

Improve First Call Resolution, call history and cross-department integration.

Workload Organization

Gain actionable data on key metrics such as workload, efficiency, and resource allocation.

Workforce Management

Harness real-time production insights to enhance healthcare workforce management. Empower teams and decision-makers with dynamic analytics to address issues, optimize resource allocation, and ensure timely service delivery, ultimately elevating overall healthcare performance.

Personalized suggestions to optimize work balance, boost productivity, and elevate efficiency.

Weekly coaching insights, uncovering opportunities for strategic improvements.

Tailored guidance, fostering enhanced work habits and encourage collaborative dialogues.

Week-to-week progress reports on performance and habits.

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 goal-setting and week-over-week comparisons.

Monitor productivity and efficiency ensuring the availability of focused time for creative thinking, problem-solving, and professional growth.

 

Analyze productive and focused time to reduce distractions and improve focus habits, enhancing overall efficiency and task engagement.

Workload Management

Explore latent opportunities within healthcare settings. Acquire crucial insights encompassing personnel, procedures, and technology in order to start fostering heightened efficiency, risk mitigation, workflow optimization, and the cultivation a health-conscious work environment.

  • Leverage InsightPro’s analytics to identify bottlenecks and streamline workflows, ensuring efficient resource allocation and task assignments for peak workforce performance.
  • Utilize InsightPro to assess skill sets and experience, guiding strategic resource realignment to maximize employee potential and cultivate a versatile, high-achieving workforce.
  • Employ real-time insights from InsightPro to monitor workforce productivity, driving proactive adjustments and tailored coaching for ongoing performance refinement and operational excellence.
  • Optimize task distribution through advanced algorithms, factoring in task importance, employee tenure, and expertise which leads to effective resource use and timely task completion.

 

Search Transaction

Search Transaction

Users are able add metadata or annotations to search records, helping users find relevant calls more efficiently. Filters can then be configured to search by different options such as date, call reason, etc. This efficient access to critical information not only aids...

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Real-time Warning and Notifications

Real-time Warning and Notifications

By ensuring that CSRs have instant access to critical information, this feature empowers users to provide accurate and reliable assistance to enhance customer satisfaction and reduce grievances. It also serves as a means of communication and aids in the...

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Call Kick-off

Call Kick-off

This feature captures contact information and facilitates the comprehensive documentation of calls, ensuring that all relevant details are recorded and easily accessible. CSRs also have the ability to search for a member based on their information, streamlining the...

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Block User

Block User

This heightened level of oversight enforces strict adherence to established quality standards to prevent customer grievances. It also significantly enhances call management within workflows, minimizing errors and ensuring accurate processing.

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Auto Triaging / Deep Learning

Auto Triaging / Deep Learning

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 -...

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Inventory Management

Inventory Management

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...

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Production Forecasting

Production Forecasting

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...

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Real-time Notifications

Real-time Notifications

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...

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Check Run and Stop Loss

Check Run and Stop Loss

The Stop Loss functionality prioritizes work distribution to examiners while the Check Run holds the define groups for distribution and releases accordingly. Together, these features optimize operations and ensure effective work allocation. Now examiners can focus on...

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Block Claims

Block Claims

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...

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Inventory Management

Inventory Management

Our tool leverages both push and pull techniques in order to ensure inventory is regularly available while minimizing overproduction. By implementing and adhering to defined rules and capacity constraints, inventory is managed efficiently and better aligns with...

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Rebuttal Management

Rebuttal Management

This transparency allows examiners and Quality teams to track the status of error resolutions, ensuring accountability and visibility throughout the process. Feedback loops are then created to ensure that errors are promptly addressed and communication is clear,...

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