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Research Article

EEO. 2020; 19(2): 2066-2075


Health Care Claims Pre Processing System

Meera. S, Sharmikha Sree R, Sohna. K, Roopika. R, Manasvinii S R.




Abstract

Healthcare is a field with a lot of room for improvement thanks to cutting-edge technology. Validation and identification of inaccurate claims consumes 8 to 10% of the time and money in the current Healthcare Business Process Outsourcing market. They don't have effective, quick, and direct communication between insurers and claimants. An interactive Chatbot connects insurers and claimants in the proposed Healthcare claims pre-processing system. This chatbot, which is powered by AI and runs on the cloud, will pre-validate and successfully register claims. Claimants communicate with the bot via a device connected to a messaging platform, where the bot can initiate an activity and respond with real-time data from a database. As a result, the cost and effort required by Third-Party Agencies (TPAs) to process claims will be dramatically reduced. By capturing denials, you can limit the number of unwanted claim requests.

Key words: Healthcare






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