Healthcare providers are increasingly focused on several key areas of AI automation to help improve efficiency, reduce burnout, and enhance patient care. Current trends and priorities, support AI process automation for purposes like:
Datrics Healthcare solutions integrate seamlessly with existing workflows, demonstrate clear ROI, comply with privacy regulations, and most importantly, allow your teams to spend more resources on direct patient care rather than administrative tasks.
As for ROI… Our team engaged in a few programs, like automation of the claim processing of Workers Compensation, Process improvement of MDP adjustments and coverage, insurance claim processing, fraud detection and cost forecasting. In any one of them, our team has witnessed the immense financial impact. The integration of our AI based system contributes to smart automation of complex tasks.
A few impactful examples:
Datrics Healthcare vertical solution uses advanced analytics in combination with available information like MACRA, MIPS, MDP, SNOMED and others, to ingest guidelines, integrate with medical, anatomy and pharmaceutical data sources as well as specific policy documentation. The relevant information is orchestrated through a workflow, driving approval recommendations and automation in support of providers, insurers and claim adjusters. Our platform has a high rate of accuracy, programmed to avoid 'AI hallucinations' and provides ROI through process automation with 'Human in the loop' capabilities.
Our software tools are flexible and integrate into your flow-of-work, utilizing AI agents to process the data, automate approvals, apply complex logic and detect anomalies for fraud and error reduction.
Provider Claim creation support - With the Datrics solution, insurers and healthcare providers can automate the task of processing the insurance claim with support for Clinical, medical terminology and definitions from sources like SNOMED, ICD-10, and RXNorm, and validating them against scheduled appointments, prescriptions and their recommended treatment.
Insurer Claim processing support - The process of matching claims with policy allowance and producing a determined recommendation, with or without ‘Human in the loop’ while tying the recommendation to the appropriate documentation and guidelines
Claim adjuster decision support - Using advanced AI algorithms and process orchestration tools, Datrics provides claim adjusters with tools to verify the validity and accuracy of a claim and an array of options from auto-approval or denial of claims assessed with high accuracy, through semi-manual review for claims with missing or questionable information.
Datrics is a no-code platform providing repeatable and secure AI capabilities with full transparency. We operate in your tech environment, integrate seamlessly through APIs and user interfaces into the platform you use. Datrics provides a natural language interface for data and process interactions, making processing, reporting and analysis a simple practice to deploy and use.
In the first phase of our rollout, Datrics addressed Revenue Cycle Management in support of
Our system drives cost reduction through automation, increase in processing speed and accuracy, and improved coverage of credits and benefits to the organization.
Datrics transformation principals
