Intelli-Claims is an Evidence based Medical Adjudication application!
STGs-N-Analytics – a group company of InCHES has designed a path breaking, IT integrated system developed on established and accepted Standard Treatment Guidelines with Rule based analytics incorporating the entire care pathway and fraud/ abuse triggers driving an intelligent scoring platform to perform medical adjudication of health insurance claims in real time.
Driven by a team of generalist and specialist medicos with an enviable IT team, Intelli-Claims will benefit the health insurance industry in several ways:
- Address the perennial shortage of well qualified doctors to handle health claims; well-trained non-medico Data Entry Personnel and an insurer specific slider is enough for Intelli-Claims to deliver upto 70% STP results
- Large numbers of claim handling team giving EXACTLY the same results – unheard of in Health Insurance Claim settlement
- Reduce time taken to process a claim
- Contain fraud, abuse as well as leakage
- Continual update of medical guidelines, drugs database and truant providers