Intelligent Automation

Harness the power of Big Data, ML and AI. Reduce points of friction with your customers and within your enterprise.

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August 18, 2022

Leveraging AI and Analytics to Transform the Future of Healthcare

Chief AI Officer at Unscrambl.ai discusses impact of AI in Healthcare

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August 23, 2022

How Teams and Leaders Can Unleash the Power of Agile

Ron Lichty, Interim VP Engineering & Author, discusses Agile practices

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How AI Can Transform Healthcare? Disambiguation of Healthcare Data

AI is a means to get access, identifying patterns and trends in healthcare data

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  • Converting unstructured data such as notes, films, photos, etc. to data that can be integrated with patient data
  • Aggregating data from wearables into mainstream patient data
  • Improving administrative side of being a provider such as optimizing supply chain and procurement costs, automated
  • patient scheduling and notification, interfacing with legacy technology, etc.
  • Automated and private patient intake
  • Eliminate bias and disparity in patient care
  • Automate common tasks such as eligibility verification, claim status follow-up, test scheduling, and payment authorization by collating data from disparate systems
  • Process unstructured data such as faxes and handwritten authorization notes to ensure seamless flow of data across providers and payers
  • Optimize revenue cycles for providers and payers with reduced declines
  • Medical and Pharmacy Claims Processing

80% of existing healthcare data remains unstructured, rendering it mostly useless across the healthcare continuum. Intelligent Automation leverages AI to transform data, introducing it into the business operations for valuable insight.

Much like prior authorizations this is an intersection point between payers and providers.

While the processes are different between payers and providers, intelligent automation will speed up the end-to-end process, improve productivity, yield higher quality, and ensure compliance to regulations.

Prior Authorizations

Optimal decision making for authorization requests requires speed and accuracy, but reliance on paper-based processes works against both. For the customer awaiting a specialist or medical procedure, a delay in authorization can be a major source of frustration.

Excellarate’s Prior Authorization solution enables a streamlined authorization processing that eliminates the paper and drives smarter decision-making, better customer service, and higher productivity.

Find Out How
Automates processes and workflows, improving accuracy while speeding up the overall process
Simplifies decision-making by consolidating all relevant data, rules, and history in a single location
Distributes work to the right staff, providing a collaborative workbench
Leverages and enhances the usability of existing line-of-business systems
Promotes quality and consistency using automation and integrated rules
Satisfies all prior authorization requirements with specifically-designed user interfaces

Appeals and Grievances

When complex, knowledge-based operations rely on manual, paper-based processes, the results are low productivity and a diminishing bottom line. Excellarate’s solutions for Appeals and Grievances solutions help to transform operations.

Faster, Smarter Investigations

Case information is captured, cataloged, and stored in a central location, then automatically prioritized and distributed

Increased Bottom Line

Automated processes reduce incidence of error, maximize resources, and speed up case resolution, reducing administrative costs and maximizing revenue potential

Simplified Compliance

Confidently comply with contractual obligations as well as state, federal, NCQA, and group regulations using case tracking, reporting, and comprehensive audit trails

Higher Customer Satisfaction and Retention

Automated processes and robust digital cataloging system enable faster case resolution and promote rapid member access to care and claim payments

Increased Employee Productivity

All relevant case information is easily stored and accessed in a single location, which eliminates time lost searching for documents and simplifies decision-making

Greater Agility

Automated functionality locates and returns information quickly, enabling faster response times to information requests from customers, legal discovery, and regulatory requests

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