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The Administrative Agent (Claims and Accounts Management) automates the analysis and management of medical claims, quickly identifying inconsistencies in billing processes and proactively suggesting corrections. This agent uses artificial intelligence to cross-check data from care, procedures, and contracts with health insurers, ensuring greater accuracy and agility in recovering pending amounts, reducing financial losses, and increasing operational efficiency.
1. Revenue recovery: Increases the recovery rate of denied amounts by quickly detecting inconsistencies and expediting corrections.
2. Reduction in rework: Automates manual processes of review and resubmission of claims, optimizing the time of administrative teams.
3. Prevention of future claims: Identifies recurring error patterns, allowing adjustments in internal processes to avoid new issues.
4. Increased operational efficiency: Reduces the average time to resolve claims, accelerating the institution's financial flow.
5. Reports for decision-making: Provides detailed insights to optimize relationships with insurers and improve billing processes.
Complete Health Clinic, facing a high volume of monthly claims:
The agent automatically analyzes rejected accounts, detecting that x% of claims are related to procedure coding errors.
Suggests the necessary corrections and resubmits the corrected claims to insurers, recovering x% of the denied amounts.
Generates monthly reports identifying frequent inconsistencies with a specific insurer, allowing the clinic to adjust submission processes to reduce future claims.
1. Revenue recovery: Increases the recovery rate of denied amounts by quickly detecting inconsistencies and expediting corrections.
2. Reduction in rework: Automates manual processes of review and resubmission of claims, optimizing the time of administrative teams.
3. Prevention of future claims: Identifies recurring error patterns, allowing adjustments in internal processes to avoid new issues.
4. Increased operational efficiency: Reduces the average time to resolve claims, accelerating the institution's financial flow.
5. Reports for decision-making: Provides detailed insights to optimize relationships with insurers and improve billing processes.
Complete Health Clinic, facing a high volume of monthly claims:
The agent automatically analyzes rejected accounts, detecting that x% of claims are related to procedure coding errors.
Suggests the necessary corrections and resubmits the corrected claims to insurers, recovering x% of the denied amounts.
Generates monthly reports identifying frequent inconsistencies with a specific insurer, allowing the clinic to adjust submission processes to reduce future claims.
Claims and Accounts Management
Automation of the workflow for analyzing, correcting, and managing medical claims, ensuring greater accuracy and agility in processes.
An essential solution to maximize revenue recovery, optimize billing, and reduce financial losses.
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