What We Do
We help healthcare providers recover revenue by identifying, fixing and resubmitting claim errors with our proprietary AI platform, “Daniel”.
Machine Learning and Gen AI delivers recommendations to reduce claims denials to drive revenue recovery by identifying and resolving claim errors, followed by automated resubmission.
1. Pattern recognition
A base model that leverages the historic billing patterns of providers along with the corresponding denial patterns of insurance carriers
2. Analysis
The next set of denials are analyzed through a suite of ML algorithms that identify key features in claims that impact the denials at the claim line.
3. Recommendation
The algorithm recommends revisions to maximize the probability of payment for that line.
4. Precision
Focusing on Precision as the key performance indicator to ensure minimal to no false positives the model is carefully tuned to control volumes analyzed.
5. Optimization
The key to model optimization is large volumes of historic paid, denied and resubmitted/paid claims.
