AI Assistance for Healthcare Payer Operations
Our AI solution increases facility claim reviews by up to 20x
Experience Faster, Smarter Claim Reviews
Our AI solution increases facility claim reviews by up to 20x. Whether it’s itemized bill analysis, clinical chart interpretation, or medical necessity evaluations, our AI assistant provides the expertise you need to expedite each step confidently.
Key Features:
- Efficient Medical Record Processing: Extract and summarize key information from doctor’s notes, patient treatment plans, and medication records with precision.
- Billing Verification: Eliminate unnecessary charges by autonomously verifying billed charges against medical records.
- Enhanced Clinical Validation: Validate medical necessity, conduct utilization reviews, and confirm accurate DRG (Diagnosis-Related Group) assignments in a matter of minutes.
Seamless Claim Processing, Greater Savings
Our AI solutions allow you to achieve more with less. By integrating advanced AI technology, healthcare payers can increase productivity, generate more savings, and ensure accuracy in each claim.
- Unstructured Data Processing: Transform patient treatment plans, lab results, and medical records into actionable summaries instantly.
- Boost Staff Productivity: Increase your review volume without adding to your workforce or operational expenses.
- Accurate, Evidence-Based Results: Our AI solutions provide source-backed responses, ensuring trustworthiness and compliance in all claim determinations.
Advanced Claims Editing: Precision and Transparency
Backed by machine learning, our AI solutions analyze each claim line item with unparalleled accuracy. Our proprietary OCR technology quickly digitizes unstructured bills and medical documents, enhancing review quality and transparency.
- Forensic Bill Reviews: Detect unbundling and errors, confirm the accuracy of implant, surgery, and specialty Rx claims, and ensure compliance with industry standards.
- Reliable Clinical Review: Partner with our team of registered nurses and certified coders for robust, defensible claims.
- Efficient DRG Validation: Confirm DRG assignments and related charges against coded diagnoses and discharge statuses, ensuring the integrity of each claim.
Next-Gen Claims Platform for Total Insight
Gain full visibility over your claims with our real-time, highly transparent review platform. Track each claim’s status, view detailed charge discrepancies, and monitor delivered savings all in one place, facilitating more informed decision-making.
Discover the Future of Payment Integrity
Let our AI solution revolutionize your approach to payment integrity with AI that takes care of the heavy lifting. Ready to transform your claims process? Get started today!