Industry challenges
File volume
Thousands of claims and reimbursement requests to process daily.
Prescription consistency
Do the billed medications match the doctor's prescription?
Insurance coverage
Verify patient entitlements and coverage rates before each procedure.
Document fraud
Detection of falsified prescriptions and billing inconsistencies.
Documents processed
- —Medical prescriptions
- —Claims forms
- —Insurance cards and policies
- —Hospital invoices
- —Pre-authorisations
- —Medical reports
- —Admission forms
- —Entitlement certificates
Automatic validations
- ✓Billed medications = prescribed medications
- ✓Prescribing doctor registered with medical council
- ✓Patient entitlements verified at date of care
- ✓Billed amount compliant with standard tariff
- ✓Date consistency between prescription and care
- ✓Patient identity verified across all documents
Measured results
85%
time saved
+25%
fraud detected
-45%
reimbursement delay