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Reduce Claims Processing Times By 20%

Accelerate claims resolution by simplifying and automating complex claims processing tasks with AI agents.

 

Get from claims to reimbursement faster with Care Advisor: Claims

Claims processing in healthcare is fraught with inefficiencies—slow turnarounds, high error rates, and tedious manual work that delays care and frustrates patients. Care Advisor: Claims, part of the Care Advisor AI Accelerator Suite, transforms this critical function by using AI to automate tasks, enhance data accuracy, and ensure compliance. Now, care managers can anticipate and resolve issues before they escalate, streamlining the entire claims lifecycle for a smoother healthcare experience.

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care advisor: claims capabilities

Automate high-impact tasks with 25% improved accuracy

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workflow

Claims validation

Automate data validation, enhance claims accuracy, and minimize the need for manual reviews, streamlining the entire process for faster, more reliable results.
fraud detection

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Fraud detection + prevention

Enhance your fraud prevention efforts by integrating advanced detection algorithms that automatically identify and analyze patterns indicative of fraudulent activity, allowing you to flag potential issues early, significantly reducing the risk and impact of fraud.
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workflow

Claim adjudication

Streamline claims processing with an automated system that approves or denies based on set rules and patterns, reserving human intervention for complex cases. This approach enhances accuracy, speeds up decisions, and optimizes resource allocation, focusing expert attention where it's most needed.
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task

Denial management

Take control of denied claims, swiftly correct errors, and drive seamless resubmissions or appeals for optimal reimbursement.
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workflow

Audit + compliance checks

Perform thorough audits to ensure claims align with both internal standards and external regulations, minimizing risks and ensuring compliance.

why care advisor: claims

Optimize resource allocation to win more

Leverage AI agents to move your staff from repetitive claims processing tasks to more strategic roles, improving their productivity and job satisfaction.

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Slash administrative costs by 15%

By reducing the need for manual intervention and minimizing errors, Care Advisor: Claims helps lower administrative costs associated with manual claims processing.
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Reduce processing times by 20%

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Save up to 9% of total healthcare costs

Automate claims routing, adjudication, and reviews with AI to streamline workflows, enhance productivity, and achieve $80 billion to $110 billion in annual savings over the next five years.

Three Simple Steps to Accelerate AI in Claims Management Now

We've created a straightforward, actionable roadmap to help you explore, measure, and optimize AI's impact on your claim management operations. By following these steps, you’ll discover the financial savings, productivity gains, and improved outcomes AI can bring to your organization.

Each step provides clear insights into your current operations and shows how AI can elevate your team’s efficiency and effectiveness moving forward.

Step 1

Identify your AI-driven opportunity for cost savings
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ESTIMATE YOUR SAVINGS

Discover the potential savings for your claims team with our Opportunity Calculator. Automate critical tasks, streamline decision-making, and enhance operational efficiency to see the true financial impact AI can deliver for your organization.

Step 2

Uncover opportunities for AI-driven improvement
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START ASSESSMENT

Complete a brief survey to share your claims management priorities, decision-making challenges, and the time your team spends on administrative tasks. Based on your responses, you'll receive a personalized report highlighting specific AI-driven opportunities to optimize your claims process.

Step 3

Plan your AI-driven claims management strategy
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SCHEDULE WORKSHOP

Join us for a personalized workshop to assess your AI readiness and identify high-value use cases. We’ll collaborate on a custom readiness plan, discuss impactful AI use cases, and define success metrics. The workshop will also outline a proof of concept or pilot project for measurable improvements.

What's Included in Every Care Advisor AI Accelerator Solution?

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Platform-specific reference architectures

Pre-built architectures for GCP, AWS, Azure, and Salesforce ensure smooth integration and deployment.

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Starter code

Starter code for fast deployment

Healthcare-specific starter code tailored to scale AI deployment quickly across key operational areas.
3
Decision making in healthcare

Top 10 workflows & decisions

Each accelerator focuses on essential healthcare workflows and decisions, providing clear actions and role-specific optimization.
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ROI calculator

Quantifies the financial savings and operational efficiency gains from deploying each AI accelerator, offering a clear view of potential impact.
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managed services

Scalable managed service

Ongoing support ensures continuous optimization, helping your organization scale AI-driven efficiencies as you grow.

Let's Connect

See Care Advisor: Claims in Action

Request a demo today and explore how your organization can unlock significant cost savings and better patient outcomes through AI.

Schedule demo
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