Smart Claims
Our Claims evaluation solution enhances claims processing efficiency, accuracy, and compliance by leveraging AI, predictive modeling, and fraud detection techniques.
Automate Claims adjudication
Identify patterns, anomalies, and potential risks, enabling faster, more accurate claims adjudication and resolution.
Real Time Actionable Alerting
Reduce Claims rejects with real time proactive actions on benefits configurations, coverage determination and utilization reviews.
Fraudulent Claims prevention
Pattern based real-time anamaly detection using AI to prevent fraudulent claims.
Promote flexibility and choice for patients and providers
Using AI for utilization management provide medication choice in real time for both patients and providers, improving outcomes.
Our Solutions
Our solutions are focused on addressing challenges across all stakeholders within the healthcare ecosystem using the eXplainable AI (XAI) platform as the foundation.
Smart Claims
A solution that automates the evaluation and adjudication of insurance claims, reducing processing times, minimizing errors, and improving claims accuracy and customer satisfaction.
Our solution enhances claims processing efficiency, accuracy, and compliance by leveraging AI-driven analytics, predictive modeling, and fraud detection techniques to identify patterns, anomalies, and potential risks, enabling faster, more accurate claims adjudication and resolution.
Precision Care
Enable segmentation of patient populations based on demographics, health profiles, and behavior to personalize care delivery, improve outcomes, and optimize resource allocation.
Predict the likelihood of patients discontinuing services or switching providers based on demographics, historical data, patient interactions, and health outcomes.
Improve patient adherence to treatment plans, medication regimens, and follow-up appointments based on historical data, patient characteristics, and behavioral patterns.
Data Obfuscation
A solution that anonymizes sensitive data to protect privacy, comply with regulations, and mitigate the risk of data breaches.
Our solution safeguards sensitive information, reduces the risk of data exposure, and ensures regulatory compliance by replacing identifiable data elements with realistic but fictional values, preserving data utility for analytics and research while protecting individual privacy and confidentiality.
Proactive Controls
A solution that centralizes and automates compliance controls monitoring, tracking, and reporting to ensure adherence to regulatory requirements and internal policies.
Our solution provides real-time visibility into compliance status, identifies potential risks and violations, and enables proactive remediation actions, enhancing governance, risk management, and compliance (GRC) effectiveness while reducing compliance-related costs and exposures.
