Transforming claims through advanced analytics to improve decisions

IntelliPayer Claim

IntelliPayer Claim is a powerful claim analytics solution designed to solve potential issues faced by the healthcare payer industry. Integrated with computational modelling, data mining, analytics technologies, and time scale analysis, our claim solution can help payers to optimize their claims process, ensure payment integrity, and manage costs.

Business Challenges

Today's healthcare organizations are facing the demand of meeting healthcare reform mandates, consumerism, managing cost, payment integrity, lengthy claims management process, and unhappy customer experience. The shift to fee-for-service/value reimbursement model is driving payers to work with huge volumes of data and make timely decisions.

Identify right mix of assets, partners and processes for efficient claims processing

Strict processing guidelines

Lack of business insights

Delay in claim processing

Inability to seamlessly integrate data from various systems

Key Features

Data source integration

Integrate data from multiple sources to provide key stakeholders with a complete, consistent view

Analysis of historical data

Aggregate and share historical claims data to validate new claims using predictive analytics

Full compliance framework

An end-to-end claims transformation solution to streamline claims processing workflow

3600 view of claims

Get comprehensive detailed roadmap to implement and ensure adherence to care plans

Information at the fingertips

Easily access your healthcare information, estimate costs, and manage claims effectively

Complete transparency

Transparency into the history of claims data to make cost-efficient decisions

Business Benefits

Our claim analytics helps payers in improving the quality of care and the health of the membership base, which helps to process
claim faster, reduce cost, and minimize fraud.

Lower claim cost

Easily manage, control and reduce claims costs

Quick claim processing

Reduce claims processing times, and bring greater efficiency

Optimize reimbursement claims

Optimize reimbursement claims and underpayment recovery directly

Accurate claim assessment

Improve claims adjudication process by detecting and modifying issues at their source

Find the solution that meets your need


From member growth and retention to medical cost management, IntelliPayer is opening up other avenues and opportunities in healthcare, which includes combating fraud, driving product design, and strengthening quality of service delivery etc.

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