ARTIFICIAL INTELLIGENCE

Our AI solutions harness the power of data to help transform care outcomes, reduce waste, and improve financial performance.

AI TECHNOLOGY IN HEALTHCARE

We're using artificial intelligence to help solve healthcare's most costly problems.

We connectservices and data to help eliminate silos between patients, providers, and payers.

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Eliminating workflow inefficiencies and removing barriers to collaboration

Our practical approach to AI focuses on making healthcare more efficient and cost-effective. Today, solutions and services across our portfolio use AI to help customers improve payment accuracy, reduce denials, enhance payment forecasting, and slash administrative overhead.

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Improving claims lifecycle management with AI-powered reimbursement solutions

With AI across our platform and embedded into our claims management workflow, we help payers and providers optimize claims processing and prevent denials before claims submission.

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Utilizing Natural Language Processing (NLP) to improve the healthcare journey

NLP is an innovative form of AI that converts human language into a computer-compatible format to perform computational analysis to gain insights. We use NLP to classify, extract, and summarize information from EMRs and from medical, policy, and contract-related content. NLP-centric-use cases help improve the patient experience, clinical experience, and operational efficiencies, and reduce the cost of care.

What’s included in Artificial Intelligence

  • Natural Language Processing (NLP)

    • Technology that classifies, extracts, and summarizes information from EMRs and from medical, policy, and contract-related content
    • Converts human language into a computer-compatible format to perform computational analysis to gain insights
    • Use cases include risk adjustment, auto-review, auto-audit, and HEDIS®
    • Helps improve the patient and clinical experience and operational efficiencies and reduce the cost of care

  • Conversational AI

    • AI-powered virtual assistants such as voice bots and chatbots to serve multiple purposes along the customer’s healthcare journey
    • AI that provides conversational, humanlike dynamics
    • Helps reduce call-center costs, improve customer satisfaction, and enable the ability to handle higher call volumes
    • Use cases include patient access, patient-eligibility screening, National Payment Connector (NPx) LiveAgent, and NPx Chatbot

  • Predictions

    • Machine learning-based predictive-use cases to help improve internal and external workflows
    • Help identify data patterns ranging from denial prediction to missing charges
    • Aid in reducing cost of care and improving care quality
    • Use cases include charge capture, denial prevention, eligibility and enrollment, Coordination of Benefits, InterQual® Level of Care Criteria, denials management, and workforce optimization

  • AI in Clinical Decision Support

    • AI is used to help enhance decision-making in the clinical workflow
    • Helps reduce medical-review time for case managers by auto-completing medical necessity criteria, applying NLP, and inferencing from image texts
    • Used to help increase quality of care by recommending evidence-based practices at appropriate points of care
    • AI-based inferencing has been used for solutions such as InterQual® AutoReview and CareSelect®

Innovating healthcare with AI-powered solutions

DISCOVER WHAT OUR AI-ENABLED TECHNOLOGY CAN DO
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