Fact sheet: Itemized Bill Review
View fact sheet (PDF 189kb)
See how artificial intelligence standardizes bill descriptions, incorporates legislative regulations, then flags and routes errors to the appropriate clinical specialist.
We determine the accuracy of high-cost claims and solve for the most complex claim reviews. Our technology combines artificial intelligence with clinical code mapping and legislative regulations. This ensures accurate payments are determined quickly.
Itemized bills include hundreds of pages and thousands of non-standard line item descriptions. Our system normalizes the data, flags the errors, and routes the bill to a specialized clinician.
Our clinical specialists support findings with regulatory guidelines and plan details. Resolution experts partner with providers to enhance relationships while leveraging and defending findings and training on appropriate billing processes for future cases.
We take complex, high-dollar claims and simplify them by normalizing the line item details through natural language processing.
From there, we maximize the time of clinical experts by providing them pre-flagged claims that are within their specialty. This allows them to quickly review and make a correct determination. The system continues to learn as clinicians accept or deny flagged items.
Our solution averages 10% savings on what was originally payable and has a 98% uphold rate of findings.