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How it Works
- Analyzes accounts before submitting eligibility and claim status requests
- Machine Learning detects and corrects inaccurate patient and claim information before submitting requests
- Enables real time corrections to data to increase the success rate of responses
- Ongoing additions to rules provides a comprehensive solution based on provider geography and payer mix
- Available as a service for internal use on a license basis
Description
Our comprehensive rules-based pattern analysis solution detects and corrects inaccurate patient and plan information resulting in a 20% - 25% improvement rate in receiving successful claim status responses, which are critical for avoiding costly and time consuming calls to payers. Our AI Pattern Analyzer builds upon the efficiencies gained from our Payer Master – ID Matching as a service by considering changes to patient and plan data based on demographic and external databases.
