$8.1 billion
Global Sports Medicine Market Size Value
92%
Of U.S. Citizens Had Health Insurance At One Point During 2019
$671.1 billion
Medicaid Spending In 2020
EXECUTIVE SUMMARY
TensorIoT completed Database Record Re-Duplication with insurance records for the client, delivering an automated data processing system to help streamline billing.
GOAL
How can you use technology to rapidly extract document for analysis and use in accurate automated insurance billing?
RESULTS
The client has a substantial reduction in unpaid claims and optimized their understanding of the payer’s ecosystem.
Background
The client is a leading orthopedics and prosthetics company that prioritizes cost efficient and convenient solutions for their patients. They needed help with ingesting the wide variety of incoming insurance claim data into an affordable storage option, with the ability to query the document dataset and receive visualization created from those documents to be able to derive business value through visualization of the data using AWS.
The Challenge
Although our client sells their products directly to patients, the majority of our client’s transactions were paid for by insurance companies. Due to messy human input, the manual effort required to determine the payer often proved difficult, leading to a substantial number of unpaid transactions.
The Solution
TensorIoT used HIPAA compliant OCR and machine learning workflows to process new and existing medical records and reliably identify the payer, enabling accurate automated billing. The ingested data is structured to enable additional ML use cases including predicting whether a given payer’s approval criteria has been satisfied.