Automated, Touch-less and End to End Platform for cashless (Planned or Emergency)and post-discharge (Reimbursement) claims processing with instant payout under 15 Minutes.

Customer Driven Health & Medical Claims AI Platform Instant. Customer Driven. AI Based.

CASHLESS CLAIMS (EMERGENCY OR PLANNED)- AI Based Automated claims platform under 10 minutes. Take photo of hospital bills estimate, KYC, health card, consulting report, pre-authorisation form etc and ALFRED will do OCR/ICR, QC, Health claim profiling, medical coding and estimating final claims payout.

POST-DISCHARGE OR REIMBURSEMENT CLAIMS -AI based claims settlement platform under 60 mins. Upload or take photo of hospital bills, pharmacy bills, consulting reports, claims form, kyc, cancelled cheque, procedure or diagnostic reports, and ALFRED will take care of everything further to enable final payout.

Medical & Health Claims Platform for TPAs & Brokers: Medical & Health Claims are painful process for TPAs and Brokers as they are customer front businesses. Delaying in claims or rejection in claims are challenging and reducing their revenue too. ALFRED provides AI enabled solution to file for claims automatically by reducing errors, cost and also increasing chances of claims approval. Get instant claims estimate and shortcomings in filing if any.


Business information

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  • Functional details

    1. API Driven Health & Medical Claims Infrastructure with OCR/ICR, Image recognition, QC, ICD/DRG code mapping, Inclusion & Exclusion Policy check, Evidence Based claims assessment, Risk & Fraud Intelligence and Claims Price Calculation for Final Payout under 10 Mins.
    2. Reducing manual processing.
    3. Reducing risk & fraud.
    4. Reducing claims Opex cost.
    5. Reducing claims processing time.
    6. Empowering customer experience with trust.

  • Business problem

    Health claims is lagging of innovation and hence the existing process for claims filing, claims assessment, claims prediction, denial prediction, claims settlement and payout are challenging, time taking, manual & complex. These also leads towards increase in risk & fraud and losses to insurance companies. On the customer side, high loss to insurance leads to delay in claims process  and thus loses customer trust, transparency.

  • Business opportunity

    • Health Claims is the prior need of every individual across the world
    • TPA, Hospitals, Patients all are struggling to get claims on time
    • Insurance companies are struggling to standardize claims process due to unstructured documents, time taking process, manual processes and no intelligence
    • Per claims spending are very high
    • Instant claims are not available and hence patients loses trust

    This enables businesses opportunities for more than $Trillion across the globe. Health claims are basic needs and it becomes more important to provide seamless, instant and personalized process using technology. 

  • Return on investment

    • Reduces time for claims process and settlement by 90%
    • Reduces risk & fraud 
    • Reduces cost for claims processing 
    • Enables customer happiness and trust 
    • Increases revenue for TPA and Insurance companies 
    • Reduces financial burden on patients 

  • Competitive advantage

    • ALFRED by Artivatic, provides end to end claims automation under 15 minutes 
    • Uses patent pending technologies to asses data and map it to the evidence based instant claims prediction
    • In-depth historical profiling for upcoming claims 
    • In-depth risk & fraud detection with medicine data, pharmacy  bills and more
    • Millions of data for prices, diseases, medicine and more
    • Unified and patent pending health profiling technologies 

  • Industries

    Government, State/Provincial/Local Industry
    Healthcare Industry
    Insurance Industry

  • Solution areas

    Healthcare and Pharmaceutical
       Clinical Care
       Patient Care and Services
       Physician Office Automation
          Claims administration
          Health information systems
    Insurance
       Administration Systems and Services
          Claims Administration
       Core Insurance

  • Customer size

    Midmarket Business (100 to 499 employees)
    Midmarket Business (500 to 1000 employees)
    Large Business (greater than 1000 employees)

  • Languages supported

    English

  • Countries/regions available for distribution

    United States

    Australia , Hong Kong S.A.R. of China , India , Indonesia , Japan , Malaysia , Nepal , Singapore , Sri Lanka , Thailand , Viet Nam

    United Kingdom

    United Arab Emirates

  • Solution collateral

    Name Date Categories
    Jun 3, 2020 News/Marketing
    Products
    Services
    Fact Sheet
    Sales
    Platform Summary
    Value Proposition
    Jun 3, 2020 Platform Summary
    Value Proposition


Technical information

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  • Hardware/OS platforms

    Ubuntu 16
       IBM Systems: z Systems
       IBM Systems: Power
    RHEL8
       IBM Systems: Power
       IBM Cloud

  • Software

    Cloud and Data Platform
       IBM Cloud Pak for Multicloud Management
          IBM Cloud Pak for Multicloud Management
    Red Hat
       Storage
          Red Hat OpenShift Container Storage

  • Cloud services

    Cloud Capability
       Bluemix
          Bluemix
       SoftLayer
          SoftLayer

  • Storage devices

    Cloud Storage Systems
       IBM Cloud Object Storage System


Date last modified:    Jun 19, 2020


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Contact information

Layak Singh
+919557162244


Company

ARTIVATIC DATA LABS PRIVATE LIMITED
#18, ENZYME JNC BUSINESS CENTER
GUAVA GARDEN, KORAMANAGALA 5TH BLOCK
Bangalore, Karnataka 560095
India

+91 80 41502526


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