ALFRED — Unified AI Health Claims Automation, Risk, Fraud & Decision Platform
As you are aware, Insurtech is picking up throughout the world. However, the users’ movements patterns have completely changed post-COVID. What was true before isn’t true anymore.
COVID-19’s most impact is on Health, it may be individual, family, employee or relatives. Due to this more & more health claims are also getting notified to Payers/Providers. This has impacted the business process, cost, efficiency and customer experience.
To better solve these problems, it is utmost important to have solutions that can do end to claims processing by optimizing the process, enhancing efficiency, reducing risk & fraud, enabling better customer experience.
Artivatic.ai’s flagship product ALFRED’s Health Claims is an AI Based smart claims automation, auto adjudication, risk & fraud and decision platform that takes care end to end processing & settlement. TPA, Providers, Clinics, Corporate to Payers all can connect /integrate with quick APIs.
ALFRED’S AI/ML Based Health Claims Platform will provide:
- Automated Claims — Cashless, Post-discharge & Hospicash
- OCR/ICR for medical documents/bills/pre-auth [printed/handwritten]
- Claims Auto-Adjudication
- Digitization and processing
- Claims Leakages & Admissibility
- Risk scoring & Fraud Intelligence
- Automated ICD/IRDA Coding /Billing
- Product Configuration, Inclusions & Exclusions
- Schedule of Charges configuration/Approval
- Documents Check & QC Automation
- Providers /TPA network connect and automation
- Investigation /Workflow
- Configure Discounts, Loyalty cards, Lab discounts /OPD Benefits
- Digital Claims Filing, Tracking & Progress Journey
- Payments, Tracking & Update
- Workflow & Process for claims processing
- Internal communication/meeting/discussions
- Dashboard & Insights
Impact that ALFRED’S Health Claims Platform can make:
- Reducing processing cost and increase efficiency
- Data Driven Decisions
- Scale & Better Customer Experience
- Reducing TAT
- Automation & fast claims processing
- Unified & efficient platform
- Plug-in-play and API driven platform
- Reducing risk & fraud
- Reducing manual efforts
- Self Claims Filing via Providers/Customers
- and more
ALFRED’S Health Claims Platform will transform from legacy to new-age digital claims platform that not only adopts new change, new data, new processes but always keeps learning to provide better risk, insights, information and instant decision making.
Visit at Microsoft Azure Portal: ALFRED’S HEALTH CLAIMS AI Platform
Visit at IBM Portal — ALFRED’S HEALTH CLAIMS AI Platform