The Integrex Health industry leading claim status platform combines expert knowledge of payer adjudication systems with our AI Pattern Analyzer, a machine learning and AI tool that detects and corrects inaccurate patient and claim information.
Correcting and detecting inaccurate patient and claim information before submitting claim status requests dramatically increases the success rate of claim status responses by up to 25%.
Extended X12 Claims Data provides detailed claim adjudication data
- Allowed amount
- Patient responsibility
- Informative denial descriptions
- Check cashed date
Improves workflow and account allocation while significantly improving claims worked productivity
Platform Flexibility
- Normalizes data across all payers to optimize integration with workflow and practice management systems
- Interoperates with different data formats like X12 and JSON
- Supports batch file uploads and API requests
CASE STUDIES
Our payer partners that contribute Extended X12 Claims Data account for 150 million members with additional payers being added on a quarterly basis.
100002
BENEFITS
Improved Production
Production for denial teams improves 20% – 25% by automating write-offs and optimizing account allocation based on additional claim adjudication data
Accelerated Revenue
Identifying payer trends with denials and prioritizing work efforts on claims that have the best chance of being paid yields accelerated revenue
HOW AI PATTERN ANALYZER WORKS
- Analyzes accounts before submitting eligibility and claim status requests
- Machine Learning detects and corrects inaccurate patient and claim information before submitting requests
- Enables real time corrections to data to increase the success rate of responses
- Ongoing additions to rules provides a comprehensive solution based on provider geography and payer mix
- Available as a service for internal use on a license basis
