Revolutionize Healthcare Claims Processing with WiseCLAIM
Streamline medical claims workflows and reduce manual intervention with WiseCLAIM
Discover How WiseCLAIM Transforms Healthcare Workflows
The healthcare industry faces a significant challenge in managing claims due to paper-based processes, manual data entry, and compliance requirements. These inefficiencies result in delays, errors, and high operational costs.
WiseCLAIM, powered by ABBYY FlexiCapture, simplifies and automates healthcare claims processing, empowering organizations to eliminate manual tasks, minimize errors, and focus on delivering quality care. With advanced AI technology, WiseCLAIM transforms document-heavy workflows into efficient, accurate, and scalable processes.
Key Features
- Faster Claims Processing: Streamline workflows with automated data extraction, customizable export options, and integration with existing systems like email, web APIs, and scanners.
- Versatile Document Handling: Process various healthcare claims such as CMS-1500, CMS-1450, ADA Dental Claim Forms, Medicare Part D Claims, and more.
- Enhanced Data Accuracy: Leverage AI-driven automation to ensure precision in claims processing and reduce human error.
- Seamless EDI Integration: Support for formats including X12N (837, 835, 270/271, etc.), HL7, EDIFACT, JSON, XML, and CSV.
- Compliance Made Easy: Maintain industry-standard compliance with ready-to-use workflows and advanced security protocols.
- Easy Training and Self-Learning: Quickly adapt to new claim types with an intuitive training process: machine learning observes user actions to continually improve and automate repetitive tasks.
How WiseCLAIM Works
WiseCLAIM leverages cutting-edge OCR and AI technologies to transform claims processing, simplifying complex, data-intensive tasks into seamless and efficient workflows in just four steps:
Document Upload
Upload documents quickly via scanners, email, mobile apps, cloud storage, or API integration to fit your workflow.
Automated Processing
The system improves document quality, separates pages, performs OCR, and extracts key data with NLP. Automated validation ensures accuracy by checking data against predefined rules.
Verification and Validation
The user can quickly verify accuracy with flagged uncertainties, while machine learning adapts from corrections to automate future tasks.
Ready-to-Use Output
Validated data is delivered to ERP, CRM, or other systems in formats like JSON, CSV, or XML, ready for immediate use.
Why Choose WiseCLAIM
WiseCLAIM empowers healthcare professionals with intelligent automation and significantly improves the claims processing workflows.
The solution combines ABBYY® FlexiCapture’s® advanced OCR and data capture technology with WiseTREND’s flexible and customizable claims automation capabilities, enabling businesses to boost efficiency, enhance accuracy, and reduce the costs spent on manual processing.
- Eliminate paperwork and speed up claims processing: Designed for both non-institutional and institutional claims, WiseCLAIM offers exceptional accuracy and speed.
- Leverage the powerful integration with ABBYY FlexiCapture: Benefit from image enhancement, multilingual text translation, support for any document format, and simplified training for global healthcare teams.
- Achieve rapid Time to Value: With customizable workflows, seamless integration, and flexible export options, you can quickly implement the solution and realize fast ROI from your digital transformation investments.
- WiseTREND Service Bureau: Combine the power of WiseCLAIM with expert support for end-to-end claims automation.
Frequently Asked Questions
WiseCLAIM supports a variety of claims, including CMS-1500, CMS-1450 (UB-04), ADA Dental Claim Forms, Medicare Part D Claims, and specialty claims such as vision and pharmacy. It also processes Electronic Remittance Advice (ERA) forms.
Yes, WiseCLAIM integrates seamlessly with email systems, web APIs, scanners, FTP, and existing claims management platforms. It also supports various export formats like X12N 837, JSON, XML, and CSV for compatibility with other systems.
WiseCLAIM is designed to meet industry standards, including HIPAA compliance. It provides ready-to-use workflows, document classification, and secure data handling to maintain regulatory compliance.
WiseCLAIM reduces errors, enhances data accuracy, accelerates processing times, and decreases labor costs. It transforms manual, paper-based processes into efficient automated workflows.
WiseTREND offers comprehensive support, from deployment to ongoing customization. This includes user training, troubleshooting, and system optimization to ensure smooth operations and scalability.
You can choose between cloud-based, on-premise, and SaaS solutions to align with your organization’s needs and capacity.
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Expert support for end-to-end claims automation
Why Healthcare Experts
Trust WiseTREND
WiseTREND delivers AI-powered Intelligent Document Processing (IDP) solutions that streamline workflows with high-accuracy data processing tailored to industry needs. Offering flexibility, end-to-end support, and a dedicated professional team, WiseTREND empowers businesses of all sizes to optimize operations and meet industry-specific challenges.
Tailored for Healthcare
Customizable tools for hospitals, clinics, insurance providers, and healthcare networks.
Industry-Grade Security
HIPAA, HITRUST, ISO 27001, NIST, PCI DSS, and SOC-2 and other standards ensure the highest levels of security and compliance.
Comprehensive Support
End-to-end assistance, from implementation to optimization.
Flexible Deployment Options
Choose on-premises or cloud-based solutions tailored to your organization’s needs.
Our Clients
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