Inpatient Claim Automation
Inpatient Claim Automation
Forget the pain to handle piles of documents. Our solution allows every insurer to provide 7 x 24 assistance before claims even occur and process inpatient claim at remarkable speed with consistence and unbeatable accuracy.
Instant Claim Estimation
We power whatsapp and web based chatbot to provide instant claim estimation 7 x 24 and allow insurers to provide claim assistance early in the process and reduce chance of claim disputes.
Fraud Detection
Instead of relying on paper and images provided by the customers, we directly integrate with the hospitals to obtain data directly. This saves customers' effort in dealing with tedious claim processes. Fraud is mitigated by advanced OCI and AI and our direct integration with hospitals' management system.
Decision Automation
We score each claim for risk rating based on the no of claims identified as problematic by the AI model. We flag the cases to the following categories for proper decision by human, a) Rework required with reasons (such as an unclear image of invoice), b) Claims rejected with reasons, c) Claims referred with reasons, d) Claims approved and paid.
Claim made simple
Instant Claim Estimation
Our tech provides the most urgently needed answers for claimable amount estimates for anxious customers when they need to be hospitalized.
- Chatbot
- Low-code engine
Reduce abuse
Stop Fraud
Our AI model detects abnormal claim and score the claim so claim assessor can focus on cases where attention should be given and most cases can be approved right away for the perfect customer experience.
- Artificial Intelligence
- Photo Analysis
Consistently right claim decision
AI Claim Decision
Our AI digests the data from multiple sources and maps the diagnosis and treatment with standard codes and apply expert medical knowledge to determine if there is elevanted risk for claim assessor to be aware of.
What we do
How we do this?
Forensic Image Audit
We scan for any sign of photo tampering
Low Code Engine
We code medical products information via simple drag and go for fast inclusion of new medical insurance products
Plugable via API
We build by modules and fits nicely with your existing workflow via API
Advanced Analytics
We provide holistic view of the claim and explain every suggested risk to consider instead of simply flag the cash
Global Standard
We keep abreast with global standard in codification of diagnosis and medical procedure. We build a massive database to map common name used by doctors to standardised codes and do works that claim assessor without medical training cannot do.
Protection of Privacy Data
All data is encrypted and handle with care under our secured AWS infrastructure. Personally identifiable information is removed whenever possible at the earliest touch to maximize privacy protection.