An automated adjudication system for managing payments to your third-party Service Providers. AI based tools allow for easy entry of data and enhanced analysis for fraud detection and systemic product issues. The SXCL rules engine, extensive API suite and cybersecurity foundation ensure the product can support your business as it changes over time.
Why Claims?
Designed to require minimal interaction by your claims team. Claims is built with a manage by exception mentality.
Dynamic rules engine allows for easy management of complex claims rules.
AI based logic verifies claims as they are being processed.
Built from the ground up with security and integration in mind.
Key Features & Benefits
CUSTOMIZABLE RATE MODELS
A comprehensive set of easily configurable operational dashboards that facilitate the process.
Specific roles will have focused dashboards.
AI ENHANCED DATA ENTRY
AI processes support automated data entry, data validation, and product and service performance.
AI BASED ANALYTICS
Automates the entire Claims process so that minimal intervention is required.
AI Enhancements
Claim Assistant: Boost claim integrity with intelligent AI validation and auto-correction
Image Analyzer: Detect and prevent fraudulent claims with intelligent AI
Engineering Analyzer: Leverage AI to uncover engineering issues through smart claim analysis
Claims Auditor: Pinpoint suspicious claims and enhance Provider performance