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HEALTHCARE

Cognitive Healthcare Solutions that Protects Health and Delivers Efficiency

Data driven businesses are the backbone of most of the successful enterprises in the world today. Using analytics, this can revolutionize the field of healthcare for both payers and providers. It can help all the myriad specialties in the medical industry by opening new avenues of revenues and process optimizations.

Our Cognitive Healthcare Application helps providers protect their revenues while improving patient health outcomes.

We use cutting-edge data science technologies that enable us to get a precise insight into the future state of healthcare processes and patient care. This will be of great help to the healthcare community and the patients. Our mission is simple –ensure optimum use of resources and help save lives by predicting and stopping losses before they ever happen.

SOLUTION FOR PROVIDER

Optimize Billing Cycle

  • Identifies the highly critical records which need immediate follow up,
  • Clusters the transactional data to understand the patterns of where the billing default is happening and what are the factors attributing to the default.
  • Alerts schedule conflicts with document submission requirements in advance to avoid unsuccessful claim submissions.

Stop Erroneous Claim Processing

  • Analyzes and flags issues within claim documents to avoid claim denial prior to submission,
  • Analyzes and suggests terms and phrases with high likelihood of acceptance of claim documents prior to submission,
  • Reduces time spent on claim document preparation.
  • Reduces human errors in manual preparation process.

Automated Pre-Diagnostics

  • Identifies potential comorbidities based on historic visits,
  • Determines potential care plan and its likelihood of success based on medical data.
  • Provides insights into appropriate adjustment plans and duration of care required.

Recommended Physician Allocation

  • Predicts availability of specialists' and matches appointments based on appointment data and vacation data
  • Optimizes walk-in waiting time through predicting schedules and evaluation hours of physicians
  • Analyzes historic visits and identifies best resource allocation plan for providers,
  • Reduces human errors in manual preparation process

Immediate Care Plan Decision

  • Matches pre-diagnostic results and delivers best care plan decision ad-hoc,
  • Builds a working care plan schedule based on patient's condition, patient's historic schedule, and physician's availability
  • Updates care plan impact and progress charts if patients fall off schedule
  • Reduces diagnostic time and risk of choosing ineffective care plans.

Total Value Estimator

  • Determines total value and predicts future estimates,
  • Calculates patient churn and identifies key factors leading to patients’ switching care providers,
  • Evaluates resource value ratio and allows more effective resource allocation

SOLUTION FOR PAYER

Automated Claim Reconciliation

  • Engineers claim source data, reconcile claim info from multiple streams, validates claim's compliance to regulations and consolidates claim at accuracy rate of 99.97%.
  • Identifies submitted claim issues and alerts vendors for adjustments.
  • Implements system for auto-adjudicationrate
  • Locates ACH, billing and claim discrepancies and reduces claim disputes.

Accelerated Member Platform

  • Allows members to review eligibility, apply for renewal, update personal info, and achieve other actions in a simpler way,
  • Recommends actions based on member's previous activities,
  • All-in-one platform for enrollment, eligibility check, claim review, payment options, and customer dashboards.

Legacy Transform

  • Modernizes legacy systems with up-to-date technologies and capability to upgrade in future,
  • Reduces risk of underperforming and inefficient operations due to increasing demand and regulatory complexity,
  • Increases customer satisfaction with bright and simple designs in user experience,
  • Achieves faster and more accurate task delivery.

Mandate Checker

  • Keeps up with the most updated news of modifications in regulations and mandates,
  • Ensures your system complying with regulatory changes,
  • Implements meaningful use of existing mandates to your system.