i3Claim: End to end Claims Processing Automation solution
With increasing complexities and evolving consumer demands, digitisation of the claims process has become essential for insurers to ensure fast settlement & payment of claims as well as drive customer satisfaction and set standards of service.
However, traditional claims processes involve intensive document-driven operations and the processing of non-structured data in multiple formats/nomenclature, making it difficult for insurers to process claims efficiently and quickly.
i3claim helps in capturing significantly more data-points in much lesser handling time. It reduces the extent of manual data capture and human errors in the entire claims process by more than 60%, making it much faster and extremely scalable.
i3claim accepts data input from a variety of sources like Hospitals, Pharmacies and Diagnostic centres. It extracts, classifies, and standardizes non-structured data present across multiple documents.
i3claim reduces the claims process to a single queue, by automating several parallel activities. This improves efficiency and leads to a reduction in cashless discharge time from 4 hours to less than 30 minutes for 90% of the cases. AI-assisted processing covers accurate capture of Non-payable and tariff comparison on 60% of the line-items. This has led to an average of USD 200-5000 savings per claim compared to manual processing.
EMR Integration & Relevant Hardware:
End to end Healthcare and Life Insurance Claims processing automation solution.
COVID-19 use cases
COVID-19 Claim Automation: The COVID-19 pandemic has transformed the healthcare industry. Insurers are finding it difficult to process the COVID-19 claims on time resulting in delays in the discharge process. This has accelerated the need for intelligent automation solutions to reduce the overhead of claims adjudicators and ensure faster & accurate claims. CliniAId helps in handling an unexpected increase in the number of claims by automating medical adjudication and being equipped to manage the end-to-end claims process. Using CliniAId-coded medical data and clinical rules prepared by Claim officers, the system can automatically validate the claim to achieve auto-adjudication of certain claim types which substantially reduces the AHT. The solution is highly scalable and can accommodate a sudden rise in the number of claims with relative ease. CliniAid can extract medical data in claim documents to identify relevant details such as symptoms, diagnosis, treatment or procedures, medicines, etc. to help the medical officer check the medical admissibility of the case.
Healthcare Insurance providers, Healthcare TPAs, BPOs / GSIs
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