AI Products 2017-11-20T11:36:59+00:00

BigDataGuys's (AI Products) Medical Claims Intelligence Solution

Measure & predict reimbursements, costs and outcomes of claims pathways

Medical claims Intelligence for
Providers

The Medical Claims Process (AI Products)  State of Healthcare BI Today, Bigdataguys’s Offering, Implementation Framework, Business Value

Current Medical Billing Workflows

AI Products

Claims Intelligence With Bigdataguys

Business Discovery Platform, Low-Cost Solutions, Leveraging Machine Learning Techniques

CASH FLOW FORECAST

OPTIMIZATION

DENIAL MANAGEMENT

PAYER PERFORMANCE

Bigdataguys medical claims solution

Payer Performance Analysis

 

 

360˚ Visibility Access comprehensive Payer Performance details and compute scores for each Payer

Track Critical KPI’s & Metrics Monitor Payer Performance vs Key Performance Metrics in real-time.

Monthly Trend Analysis Visualize monthly performance trends for each payer and focus only on top Payers.

Real time claims intelligence

Intelligent Dashboards

Providers now have ready access to actionable insights using Key Performance Indicators and metric.

Performance Optimization:

Advanced analysis of end-to-end
claims workflows allows providers to understand process bottlenecks and equips decision-makers with insights
for improving process efficiency.

Cash Flow Forecasts

 

Predictive Models:

The solution uses time-series analysis and predictive models to provide visibility into expected cash flow while highlighting revenue at risk, based on probability of claim realization.

Increase Accuracy & Reduce Fraud:

These insights enable the provider to forecast
claims realization and track payment
discrepancies.

Solution Approach

Value drivers for claims Intelligence

Techniques

Real-Time Claims Monitoring

Root Cause Analysis 

Forecast

Performance Optimization

Pattern Detection 

Alerts/Processing status criticality

Business Impact

Highlight causes of denial and effectively reduce future denials

Provides visibility into expected cash flow while highlighting revenue at risk

Identify payer settlement pattern and map top performing payer

Effective prediction of cost and duration of claims processing brings consistency to the settlement process

Typical Benefits

10%-15%Operational Expenses (OPEX) decrease

 

10%-20%Performance increase

Analytic Offerings

Machine Learning + Predictive Analytics 

Analytical Rule-Based Engine

Visualization