Ennuviz's Claim Sense is a comprehensive solution designed to help healthcare providers and payers optimize their claims processing operations. Claim Sense is specifically designed to address three critical challenges faced by healthcare providers and payers 1) Manual Claim Adjudication Iterations, 2) Adjudication of Low-Value Claims, and 3) Reduce Cost per Transaction.
This is where Ennuviz and Celonis Combine their Strengths:
Real-time insights into pend dependencies help to reduce manual pend iterations.
Assist with fact-driven decisions on processing low-value claims that result in cost optimization.
Identifies High Volume - High touch activities in the claims process that are suitable for automation.
The overview dashboard tracks important metrics, including rework caused by pending Claims, its impact on cycle time, and potential savings. It also monitors the number of low-value claims, processing costs, and optimization potential.
The Pend dependency dashboard facilitates the identification of correlations and connections between various pend codes, enabling SMEs to revise their operational procedures accordingly. As a result, this will be a decrease in the frequency of manual claim iterations.
The low-Value Claim analytics view enables businesses to optimize their processing of low-value claims by leveraging data insights. This helps to determine the most efficient method for handling each claim, whether through auto-adjudication, automation, or manual processing.
The automation dashboard assists in recognizing and prioritizing the appropriate candidates for automation, leading to a reduction in the cost per transaction.
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