Business Transformation Through Digitalization And Automation
HEALTHCARE PROCESS MANAGEMENT SOLUTIONS
Optimizing Your Healthcare Business Processes
Datamatics BPM solution for healthcare automates and digitize the entire claims process, ensuring faster and more efficient handling of medical claims to deliver superior customer service experience. It uses AI/ML algorithms to identify fraud and correct claims errors reducing the risk of financial losses.
Combines intelligent document processing and RPA to expedite paper-based form scanning and processing with unmatched speed and accuracy, meeting all payer needs.
Claims Management
Streamlines claim settlement procedures by offering efficient claims registration, verification, settlement, disbursement, fraud management, and audit capabilities
Claims Pre-Adjudication
Adjudicate claims with accuracy using AI/ML algorithms, minimizing errors and eliminating false positives and negatives effortlessly.
Adjudication Service
Facilitate faster settlements and lower healthcare costs per claim. Ensure cost reductions in data processing with guaranteed yearly savings
Member and Provider Matching
Ensures accuracy in payment processing and facilitates direct payments to accounts with seamless patient matching process
Sales & Underwriting
Offers end-to-end solutions for contract management, sales automation, quote and rate underwriting, risk classification, and pricing modules
E-Portal
Enhance member-provider engagement with interactive web portals. Expedite claim processing and settlement through our efficient digital ecosystem.
Membership Management and Billing
Ensures complete automation of the data management system to facilitate new membership enrollment, renewals, eligibility checks, monitoring, and client billing.
Care Management
Presents user friendly, Omni-channel care management that helps payers provide on-demand support to patients
Provider Services
Revenue Cycle Management Services
Facilitates a seamless transition from the traditional ‘‘Fee for Service (FSS)’ payment model to a more integrated ‘Pay for Performance’ model, with automated coding and insurance verification
Payment Posting Services
Covers posting of payments received from Health insurance payers / members towards settlement of claims to relevant patient accounts.
CRM Services
Customer Information
Maintains updated records of patient information and related contact details
Facilitates updating of interactions in the patient, payer, and provider ecosystem
IVR Solutions
Offers all patient communication on a single platform; automates the hospital's precision care workflows and guides the patient with real-time data access
Enterprise
Provides services and software for quality management, regulatory compliance, and F&A management. Offers auditable and enterprise grade solutions.
Advantages
30+ Years of Experience
Expertise in delivering intelligent solutions for healthcare and insurance enterprises in global markets.
25 million
Claims Processed Annually. Delivered global automation projects with end-to-end models
100 million
Images Processed Annually; precise, compliant, visible audit trails for efficiency
Featured Content
Case Study
A Leading Healthcare Software Solution Provider in Asia Increased its Revenue by 30% with Healthcare Management Web App
How does automation enable Healthcare Process Management?
Intelligent Automation has the potential for institutionalizing end-to-end automation in Healthcare. It can streamline the Healthcare Process Management and improve turnaround time across different process nodes.
How does the digital platform benefit adjudication and claim processing?
The digital platform improves settlement speed and lowers operational costs. It improves year-on-year savings across the Healthcare ecosystem.
What role does AI/ML play in Healthcare Process Management?
AI/ML helps track patterns in claim processing and weed out false positives and negatives through in-built validations in the business systems.
