Generate greater value through process mining in healthcare
Root out hidden process inefficiencies to reduce
costs and improve experiences
Reveal hidden process efficiencies for fast and effective solutions
Process mining is like an MRI for your claims administration processes. It uses actual event data to identify the disconnects, bottlenecks, delays, manual activities, and hand-offs that create friction, hurt member experience, increase operating costs, and open your organization to regulatory fines.
With solutions based on real world data, not perceptions or anecdotes, your organization can increase auto-adjudication rates, improve financial and benefits accuracy and streamline cycle time. Those add up to millions of dollars saved and more satisfied providers and members.
Process mining for healthcare
We combine data from core administration and other key systems into a single comprehensive data model that enables us to visualize and trace the entire life cycle of a transaction. We literally show the friction points throughout a process and their root causes so you can make effective corrections.
Execution Management System (EMS)
EMS apps enable your operating teams to prioritize the daily activities with the biggest impact on business outcomes while avoiding information overload.
Proactive insights, prioritized tasks—such as directing complex high value claims to the most experienced service representatives—and next-best action recommendations help ensure optimal efficiency. Leverage the power of EMS apps and AI workbench to benefit all levels of your organization.
Digital twin
Create a digitized replica of your actual healthcare processes so you can test your ideas before implementing them. Predict consequences of process changes with 100% objectivity.
Digital twin enables you to simulate process changes and evaluate their impact before making a real-world change. Simulate the impact of improving claims auto-adjudication; fluctuating volumes; accuracy enhancements; new IT releases; new business rules configurations, then make the changes that will have the greatest impact.
Outcomes delivered
Identify millions in annual savings
Achieve up to 20% reduction in adjustments rate
Enable fully automated no-touch processes
Reduce provider mismatches
Related Insights
What you don’t know about your operations workflows is likely hurting your business. Process mining in healthcare reveals the friction due to workarounds, manual activities, dead ends, handoffs, and disconnects that cost time and money – and points the way toward truly effective solutions for delivering improved experiences at lower costs.
In today’s experience economy, customer experience (CX) is the biggest differentiator. The payoffs for delivering a great experience are tangible – from customer willingness to pay a premium to increased loyalty. For businesses, every experience offers an opportunity to create value – for customers as well as the organization.
The AI-First Health Plan: Leveraging cutting-edge technology to revolutionize healthcare, improve patient outcomes, and streamline administrative processes
This guide is about kicking off discussions and fresh CX thinking among your peers from various departments. This is central to the success of your initiative for two reasons.
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