BigDataGuys's (AI Products) Medical Claims Intelligence Solution
Measure & predict reimbursements, costs and outcomes of claims pathways
Medical claims Intelligence for
The Medical Claims Process (AI Products) State of Healthcare BI Today, Bigdataguys’s Offering, Implementation Framework, Business Value
Current Medical Billing Workflows
Claims Intelligence With Bigdataguys
Business Discovery Platform, Low-Cost Solutions, Leveraging Machine Learning Techniques
CASH FLOW FORECAST
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
Providers now have ready access to actionable insights using Key Performance Indicators and metric.
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
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
Value drivers for claims Intelligence
Real-Time Claims Monitoring
Root Cause Analysis
Alerts/Processing status criticality
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
10%-15%Operational Expenses (OPEX) decrease
Machine Learning + Predictive Analytics
Analytical Rule-Based Engine