Healthcare Claims Automation increases efficiency and reduces operational cost by rationalizing staffing, allocating with retraining and multi-skilling, ensuring that experienced claims agents can be devoted to higher value tasks and complex processes. Automation can also streamline settlement timelines and increase process transparency, both of which are critical drivers of customer (patient or member) satisfaction relative to claims.
The automated claims process can transfer claims in real-time from the provider to payer along with necessary medical (health) records (EMR). The automated algorithms (RPA, NLP, AI, ML, IoT, etc. help achieve Claims Automation) can process the claims and perform real-time validation of the eligibility, benefits, and provider contract along with the medical diagnostic data.
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