Payers

Unlock Insights.
Grow Revenue.
Reduce Costs.

emtelligent’s medical AI solutions put data in hands of teams across the organization to deliver new value and efficiency.

blur image Get the complete picture of health

The emtelligent advantage

01

Access previously unavailable clinical data

02

Instantlyextract the insights needed to enhance member understanding

03

Enable teams across the organization to query data, eliminating manual workflow

Payer Solutions

Seamlessly configure our solution to improve efficiency and performance in these critical areas:

Risk Adjustment

  • Eliminate manual chart review
  • Close previously unknown care gaps
  • Get reimbursement for your full member risk

Medicare STARS & HEDIS

  • Access new clinical data to create a full member profile
  • Identify new care gaps and drive improved program performance
  • Improve the clinical quality of your network through enhanced insights

Prior Authorization

  • Eliminate costly and time consuming manual review
  • Access the full patient record to increase accuracy
  • Get real-time answers to patient data inquiries

Underwriting

  • Improve pricing accuracy with enhanced data
  • Tap into the full clinical record to build member profiles
  • Increase speed of pricing, quote delivery

Care & Disease Management

  • Access new insights from the clinical record
  • Identify new members eligible for intervention and support
  • Gain a more complete view of member health history

Payment Integrity

  • Quickly compare claims to clinical data
  • Reduce inaccurate claims to lower costs
  • Improve auto-adjudication rates

Member Engagement

  • Identify member next best actions
  • Tailor interventions with member clinical data
  • Drive increased engagement in clinical programs

80%

of clinical data is unstructured and inaccessible outside of a costly and time consuming manual review process

Payers are faced with terabytes of clinical data in a variety of formats, across multiple silos and business units.

Our payer customers are actively using our enterprise-grade solution to power clinical transformations that organize their disparate data and surface the insights needed to fuel their business.  
  • Identifying hidden population risk
  • Discovering pricing and cost savings opportunities
  • Improving care team productivity
  • Powering custom app development
  • Advancing analytic needs
  …and much, much more.
Learn More

Our work in the industry

Enterprise Clinical Data Transformation

One of the largest US healthcare payers is establishing an enterprise clinical data mart, critical to their care outcome and cost reduction goals. They chose to partner with emtelligent to unlock insights using their unstructured clinical data and apply those insights to everything from actuarial improvements to population health recommendations.

Connect with us