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Software used to streamline insurance claim processing with tools for communication, verification, and analysis. - Receive claim submissions electronically and provide customer service - Make assessments and reach resolutions using automated workflows - Track claim history, policy information, and verification of claim details - Monitor for litigation and fraudulent claims with risk assessment and data analysis tools
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HealthRules® Payer is a next-generation core administrative processing system that provides transformational capabilities to health plans of all types and sizes. Named Best in KLAS in 2023 for the second year in a row, HealthRules Payer enables plans to quickly address market opportunities and stay in front of their competition. Unlike any other core administrative solution, HealthRules Payer uses the patented HealthRules Language™, an English-like vernacular that delivers a revolutionary new approach to configuration claims processing and information transparency. Gartner named HealthRules Payer a sample vendor for next-generation core administration in its 2022 Hype Cycle for U.S. Healthcare Payers Report for the 12th consecutive year.
Sapiens CoreSuite is a customer-centered, comprehensive core solution, purposefully built to meet today’s evolving digital demands. Preconfigured with robust set of core applications: PolicyPro, BillingPro and ClaimsPro, which can be used alone, or combined, creating a powerful, unified suite. With one extensively-configurable, multi-line system, insurers get the a full complement of configuration tools aggregated with future-forward technology to provide end-to-end functionality across the entire P&C policy lifecycle.
IDITSuite enables insurers, MGAs and brokers to meet critical and long-term business goals using both traditional and digitised channels. Our suite was designed with growth and change in mind and is both extendable and personalised to meet your unique circumstances.
Digital Motor Claim Management Solution provides an end-to-end platform where customers can buy, renew and claim insurance by accessing the portal through any device. Artificial intelligence (AI), Machine learning (ML), and a combination of extensive algorithms help to classify the car images into frames and identify various parts of the car to assess the damage. In most cases, the AI module can make a judgment very quickly, reducing the time from days to mere minutes. Our solution is backed with a state-of-the-art mask R-CNN algorithm which makes the platform reliable and accurate at damage detection. Leveraging Azure ML and Azure Cognitive Services, the algorithm is trained using millions of images. It identifies broken and dented vehicle parts and assesses the severity of damage to come up with repair costs and work orders instantly. With this solution, you can provide on-the-spot claim settlements and bring down processing time from days to minutes.
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Riskonnect’s RMIS system gives you the data, analytics, and insight to turn risk into a strategic advantage. Focus your time where you can make a difference. Spend less time chasing down data and more time analyzing what it means. Communicate effortlessly from the frontlines to the C-suite. Break down silos and seamlessly share always up-to-date risk data across the organization. Make decisions with confidence. Turn complicated data into easily actionable information that you can trust.
Acclaim revolutionizes the handling of claims data by digitizing documents across all formats, from traditional typed invoices to handwritten bills and prescriptions. This advanced feature ensures that no detail goes unnoticed, empowering insurers to extract valuable insights from every piece of information. Gone are the days of manual processing and deciphering illegible handwriting. Acclaim streamlines the entire process, enabling insurers to unlock the hidden value within their data effortlessly. From analyzing pricing patterns to detecting treatment anomalies, Acclaim enables insurers to drive efficiency in their claims processing.
Manage claims on a single platform, faster, more efficiently, and more fairly. - Workflow engine that allows configurable views of claims data and trends. Act on claims swiftly with real time micro-to-macro visibility - Email management with automatic triaging and routing using mined data in addition to template driven outbound emails - Drag & drop customization of workflow in response to your business needs - Prevent breach in service levels with SLA monitoring and tracking - Work within a single system with ECF integration
Simplifying Medical & Health Claims Using AI & ML Automated, Touch-less and End to End Platform for cashless (Planned or Emergency)and post-discharge (Reimbursement) claims processing with instant payout under 15 Minutes. An integrated smart AI driven platform easing and automating all your claims processing requirements. The Engine Provides end to end claims automation, assessment and decisioning. ALFRED- AI Health Claims Platform builds 360-degree health ecosystem using technology & data to transform real-time claims process and its settlements through its smart unique AI driven technology It’s a Unified platform for Patients / Providers/Payers that uses its ICR/OCR technology to extract and digitize data. Its AI driven Technology helps in analysing claims wrt to any pre-existing medical history, disease prediction, case prognosis and providing recommendations to patients and providers. Alongside it importantly provides insights to payers on having a quick automated claims