CLAIM STATUS PLATFORM

Our industry leading claim status platform combines expert knowledge of payer adjudication systems with our AI Pattern Analyzer, a machine learning and AI tool that detects and corrects inaccurate patient and claim information.

 

Correcting and detecting inaccurate patient and claim information before submitting claim status requests dramatically increases the success rate of claim status responses by up to 25%.

 

Extended X12 Claims Data provides detailed claim adjudication data like the allowed amount, patient responsibility and informative denial descriptions to improve workflow and account allocation while significantly improving productivity in terms of claims worked. Our payer partners that contribute Extended X12 Claims Data account for 150 million members with additional payers being added on a quarterly basis.

Platform Flexibility

  • Normalizes data across all payers to optimize integration with workflow and practice management systems
  • Interoperates with different data formats like X12 and JSON
  • Supports batch file uploads and API requests
Benefits
  • Production for denial teams improves 20% – 25% by automating write-offs and optimizing account allocation based on additional claim adjudication data
  • Accelerated revenue due to identifying payer trends with denials and prioritizing work efforts on claims that have the best chance of being paid