Large claim reviews are a vital, yet complex and resource-intensive, part of any organization’s payment integrity program.
For a midsize payer, Machinify was able to to reveal maximum cost savings while reducing payment timelines with the fastest speed to pay on all inpatient high-dollar prepayment reviews.
- Goal: The payer needed to efficiently maximize savings balanced against limited resources for accurate reviews.
- Challenge: Using an outsourced and outdated model, the payer was experiencing extensive turnaround times for complex claim reviews, delaying payment and increasing provider abrasion.
- Solution: Machinify’s itemized bill review bridged the gap between technology and timelines by providing our software platform as a SaaS.
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