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AI Audit HUB Empowering Accurate Claims Adjudication

With our AI Audit HUB, payers can leverage the power of predictive analytics to improve the accuracy of claims adjudication and reduce payment errors. The AI Audit HUB integrates data from various sources, including audits, call centers, recoveries, grievances, and redressal, to provide a 360-degree view of each claim.

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Key Features of AI Audit Hub

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Integration of multiple data sources for a comprehensive view of claims

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Predictive models to identify erroneous claims with supporting documentation

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Rule engine to catch claims processed outside of set mandates

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Predictive analytics to identify high-probability cases for overpayment reduction, liability, and negligence

Claims Analytics: Unlocking Insights for Better Business Decisions

With our Claims Analytics solution, payers can access actionable insights into their claims performance, identify trends and anomalies, and make informed decisions. The solution is designed to cater to the complex nature of healthcare data and helps payers quickly identify areas for improvement.

Benefits of AI Audit Hub

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FWA Detection: Identify erroneous claims and avoid incorrect pay-outs

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Executive Interactive Dashboards:Easy-to-understand visualizations of critical operational and clinical KPIs

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Appeals Reduction:Identify probable cases for appeal and resolve disputes efficiently

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Increased Efficiency:Optimize the performance of high-value claims personnel

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Pay-out Optimization: Identify low-cost claims for early closure and reduce adjuster involvement

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Our AI Audit HUB and Claims Analytics solutions empower payers with the right tools and insights to make better business decisions and improve their claims management process.

Transform your claims processing today with RSTACK’s AI Audit HUB. Request a demo now!

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