Transform Cost and Quality with Decision Intelligence

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

Document Digitization

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

Provider Education

Analyze and Identify aberrant claim patterns to proactively educate provides on best practices

Contracts Management

Improve speed to market by extracting & harmonizing data (i.e. MSAs, SOWs) to dynamically identify opportunities/risks

Population Analytics

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

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Reduction in Costs

We drive cost savings through, proactive FWA identification, reduction in manual processing, reduction in vendor spends across processes

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Improvement in Operational Efficiency

We have delivered outcomes across, claims processing, payment integrity, Claims Intake

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Quality Improvement

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

Claims Audit

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.

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Payment Integrity

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.

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Why Us

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

Re-Usability

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

Continuous Learning

Decision Agents enable continuous improvement in decision making by learning from both implicit and explicit feedback

Case Studies

How can decision intelligence help your organization?

Adopt and scale intelligent decision making across your enterprise to boost engagement and enhance operational efficiencies.