Intelligent Automation in HealthTech 
Improve Operational Efficiency and Reduce Friction between Disparate Systems  

Use AI, ML and Big Data Analytics for a seamless flow of data and decisions across different systems and enterprises 

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  • Automate private patient intake
  • Interface with legacy technology
  • Eliminate bias and disparity in patient care
  • Automate patient scheduling and notifications
  • Aggregate data from wearables into mainstream patient data
  • Improve the administrative side of being a provider such as optimizing supply chain and procurement costs
  • Convert unstructured data such as notes, films, photos, etc. to data that can be integrated with patient data
  • Process medical and pharmacy claims
  • Optimize revenue cycles for providers and payers with reduced declines
  • Process unstructured data such as faxes and handwritten authorization notes to ensure a seamless flow of data across providers and payers
  • Automate common tasks such as eligibility verification, claim status follow-up, test scheduling, and payment authorization by collating data from disparate systems

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

Learn More about Encora’s Prior Authorizations Solution

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

Encora’s Appeals & Grievances Solutions 

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 

GitMerge

Faster, Smarter Investigations 

Case information is captured, cataloged, and stored in a central location, then automatically prioritized, and distributed 

FastForward

Accelerated Bottom Line Impacts 

Automated processes reduce incidence of error, maximize resources, and speed up case resolution, reducing administrative costs and maximizing revenue potential 

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Simplified Compliance 

Confidently comply with contractual obligations as well as state, federal, NCQA, and group regulations using case tracking, reporting, and comprehensive audit trails 

UserFocus

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 

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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 

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Greater Agility 

Automated functionality locates and returns information quickly, enabling faster response times to information requests from customers, legal discovery, and regulatory requests.