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Claim Xcelerate

Claim Xcelerate leverages advanced machine learning and AI techniques integrated with Pega Process AI to revolutionize claim processing.

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Overview

Claim Xcelerate is an advanced, AI-driven healthcare claim prioritization solution designed to revolutionize the claims processing landscape for healthcare organizations. By leveraging machine learning and real-time analytics, Claim Xcelerate scores and prioritizes claims based on a comprehensive set of parameters such as claim details, patient demographics, provider information, medical necessity, financial impact, urgency, and compliance factors. This solution ensures that high-priority claims are processed promptly, reducing delays and administrative costs while enhancing accuracy and efficiency. Key features include real-time claim scoring, advanced fraud detection, customizable decision tables, and seamless integration with existing systems, all of which contribute to better resource allocation, improved compliance, and increased customer satisfaction. predictive analytics, real-time processing, compliance & fraud detection, and continuous learning are key differentiators.

Key Features

  • Score Card Model
  • Continuous Adaptive Learning
  • Work and Claim Prioritization
  • Customizable Decision Tables
  • Extensible Decision Strategies
  • Real time decision making
  • Enhanced Operational Efficiency
  • Seamless Integration with Pega Process AI
  • Dynamic Claim Priority Scoring
  • Intelligent Automation

Resources

=Maantic Inc.

Partner Name

Maantic


Tags


Offering Type

Component
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