Leverage Our Prebuilt Decision Agents To Build Unique AI Solutions
Deliver Explainable, Transparent And Assured Decisions
Build AI solutions that solve your problem
Our platform Enso enables clients to develop, orchestrate, deploy and manage Decision Agents to deliver outcomes for engagement, efficiencies and costs. Here are some processes that we transformed for our clients.
Improve Claims Auto Adjudication
Predicting and recommending the action required to finalize claims that did not auto-adjudicate
Digitize Paper Claims, Prior auth letter, faxes , medical charts, Procurement Contracts etc.
Provider Contract Risk Management
Predicting financial risk with adherence to claim payments and Provider contracts
Analyze and Identify aberrant claim patterns to proactively educate provides on best practices
Improve speed to market by extracting & harmonizing data (i.e. MSAs, SOWs) to dynamically identify opportunities/risks
Identify trends and patterns across member population to identify potential care intervention
Drive Business Impact across your processes
We offer decision agents – AI trained digital workers, with pre trained health plan expertise to help you achieve your transformational business outcomes
Reduction in Costs
We drive cost savings through, proactive FWA identification, reduction in manual processing, reduction in vendor spends across processes
Improvement in Operational Efficiency
We have delivered outcomes across, claims processing, payment integrity, Claims Intake
We have improved HEDIS, STAR RATINGS, Improved Customer Satisfaction, Member Engagement Score, Provider NPS ratings
Unlock unique value with our Decision Agent Driven Solutions
Out Of The Box I Ready To Go I Works With Your Exiting Investments I Continuously Learns To Better Outcomes
Our solution identifies incorrect payments, predicts when payments will be inadequately processed, and recommends the best course of action based on historical operational outcomes The solution continuously learns with feedback improving its ability to prevent incorrect payments.
Our solutions leverage intelligent decision agents to drive proactive discovery of pre-pay and post-pay savings across Payment Integrity Value Chain. These solutions leverage continuous learning and real time feedback across all PI efforts to generates new insights for the right intervention.
We offer a unique Decision Agent Framework with the ability to deliver explainable, transparent and assured decision-making to enable fully-autonomous processes to achieve transformational outcomes.
Speed to market
Leverage Pre-built, domain specific decision agents to quickly orchestrate them into solutions and get started immediately. Easily upskill decision agents to work within your workflows for faster ROI
Unlock the ability to re-using capabilities across different solutions enabling enterprises to create the outcome driven AI solutions
Transparency, Control, Ownership
Train Decision agents with your data, in your environment to drive transparent, explainable and trusted decisions
Decision Agents enable continuous improvement in decision making by learning from both implicit and explicit feedback