Customers expect almost-instantaneous resolution to claims. Manual claims processing, while maintaining optimum levels of accuracy, creates profitability pressures for payers, leading to unforeseen delays, higher litigations, overpayments, and unsatisfied customers.
For this customer, manually auditing claims failed to stem revenue leakage and slowed down resolution times. They were looking to automate and streamline claims processes to optimize the number of human touchpoints and make the process faster and more accurate.
Manually auditing claims to check for overpayments was leading to:
Apexon brought onboard ApexClaims, a proprietary advanced analytics platform embedded with classification and anomaly detection models, to:
With ApexClaims, the customer introduced cognitive capabilities and automation across its claims adjudication process that helped them:
Learn how we assisted a Danish business conglomerate with activities in the transport, logistics and energy sectors to implement a centralized Data warehouse to improve their data quality, analyze the business trend and performance.
Discover how we aided a leading US bank holding company headquartered in Michigan with capability enhancements that ensure a long-term process that reduces data anomaly and mismatch errors, improves operations, and mitigates risks.
Learn how we assisted a leading revenue cycle management services company in the United States in identifying opportunities to improve documentation while also modifying and automating its reconciliation and quality procedures.
Learn how we helped a large physicians group based in the US use deep learning models to improve error identification by 3x and reduce financial leakage by 40%.
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