Kofax Claims Agility™ automates processing of paper-based medical claims to improve visibility, control, efficiency and compliance while reducing costs. The solution features multichannel capture of professional and institutional claims, automatic data extraction and validation, a collaborative rejection workflow, automatic conversion to EDI and operational analytics.
Whether you are automating a highly manual process or replacing an existing OCR solution, Claims Agility can help. For highly manual operations, it enables payers and other claims processers to improve workflows by reviewing and correcting errors, and using best practice workflows for exception processing.
Claims Agility contains a comprehensive rule set that validates all data present on medical bills and can rapidly be connected to any data warehouse, claims system or other legacy databases. It includes capture and rejection workflows built on an adaptable, agile platform in which your specific exception or review workflows can easily be implemented. Claims Agility enables your organization to hit the ground running with your claims automation project, greatly reducing the time and cost of implementation and ongoing operations.
Achieve Operational Excellence
Claims Agility streamlines workflow, enforces business controls, provides clear and actionable claims performance information and drives continuous process improvement. Rejected claims are automatically routed to examiners for review and action, who may accept, correct or return claims to providers for correction and collaboration. This enables new levels of engagement with your providers, and reduces cycles and cost while speeding resubmission and reimbursement.
Improve Your Medical Loss Ratio
Cut costs, reduce time and eliminate errors from paper-based claims processes while adding visibility, control and agility for better claims management. By reducing administrative and operational costs, you can improve your Medical Loss Ratio (MLR) and avoid having to issue premium rebates.