A highly configurable adjudication solution with custom rules, forms, and workflows that enables you to manage higher volumes with greater accuracy and lower costs.
Key Differentiators:
Our powerful, easily configurable, rules engine and AI automatically adjudicate routine claims, flagging only exceptions that require human review.
Configurable claim forms and workflows that align with your processes and needs, not those of others.
Flexible rate cards set by location and payment analytics ensure that you are only paying what you should to your service partners.
The Claims solution gives you a comprehensive, easy-to-use solution for managing service-provider payments, automating claim review, and keeping your claims process aligned with your business rules.
Our dynamic rules engine and embedded AI simplify the management of complex claims rules, while a robust API suite and cybersecurity foundation help the solution integrate with your ecosystem and scale cost-effectively as your business changes.
Claims
Integration with Partners
Service operations depend on seamless coordination with service providers, part distributors, underwriters, and other business partners. SXCL’s API-based architecture is designed to integrate with partner systems so data can move efficiently across the service ecosystem.
Explaining What Happened
Claims rules can be complex, and teams need a clear record of how each claim was evaluated. The SXCL Claims solution documents the full adjudication path for each claim, including which rules were executed and what results they produced, so audit support and detailed claim explanations are readily available when needed.
Understanding what is causing failures
In conjunction with the Reporting solution, Claims provides dashboard widgets that highlight operational issues requiring attention. Users can export data, configure and schedule reports, and use AI-assisted ad hoc reporting to investigate trends, exceptions, and root causes at any time.
“Proactive AI support reduces service costs by 15%.”
McKinsey