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80% of existing healthcare data remains unstructured, rendering it mostly useless across the healthcare continuum. Intelligent Automation leverages AI to transform data, introducing it into the business operations for valuable insight
Much like prior authorizations this is an intersection point between payers and providers.
While the processes are different between payers and providers, intelligent automation will speed up the end-to-end process, improve productivity, yield higher quality, and ensure compliance to regulations
Optimal decision making for authorization requests requires speed and accuracy, but reliance on paper-based processes works against both.
For the customer awaiting a specialist or medical procedure, a delay in authorization can be a major source of frustration.
Encora’s Prior Authorization solution enables streamlined authorization processing that eliminates the paper and drives smarter decision-making, better customer service, and higher productivity.
Distribute work to the right staff, providing a collaborative workbench
Leverage and enhance the usability of existing line-of-business systems
Promote quality and consistency using automation and integrated rules
Satisfy all prior authorization requirements with specifically designed user interfaces Automate processes and workflows, improving accuracy while speeding up the overall process
Simplify decision-making by consolidating all relevant data, rules, and history in a single location
Complex knowledge-based operations rely on manual paper-based processes, resulting in low productivity and a diminishing bottom line. Encora’s Appeals and Grievances solutions help to transform operations with
Faster, Smarter Investigations
Case information is captured, cataloged, and stored in a central location, then automatically prioritized, and distributed
Accelerated Bottom Line Impacts
Automated processes reduce incidence of error, maximize resources, and speed up case resolution, reducing administrative costs and maximizing revenue potential
Confidently comply with contractual obligations as well as state, federal, NCQA, and group regulations using case tracking, reporting, and comprehensive audit trails
Higher Customer Satisfaction & Retention
Automated processes and robust digital cataloging systems enable faster case resolution and promote rapid member access to care and claim payments
Increased Employee Productivity
All relevant case information is easily stored and accessed in a single location, which eliminates time lost searching for documents and simplifies decision-making
Automated functionality locates and returns information quickly, enabling faster response times to information requests from customers, legal discovery, and regulatory requests.