Jeff Francis
Vice President and CFO at Methodist Health System
Claim status automation speeds up claim resolution
AI-powered claim status automation tells your revenue cycle team what to touch and when, resolving claims faster, reducing timely filing limits, and improving efficiency.
Automatically obtain up-to-date status information
Claim Status Automation
Is your team wasting valuable time statusing each claim? Or not checking them at all? AI-powered Claim Status Automation from AKASA can improve these processes. Our automation does the work for you, proactively checking the status of claims to prioritize follow-up efforts and help you get ahead of problematic accounts. The results? Reduced staff burden and A/R days.
We removed 71% of accounts from staff queues
How Claim Status Automation works
Our AI simultaneously works on a batch of accounts at a time and cascades through various search options to find a matching claim. Status check results are interpreted by our machine learning or RCM experts and returned to your EHR. Accounts requiring intervention are routed to different work queues for your staff or AKASA to prioritize follow-up.
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CHECKS STATUS
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INTERPRETS RESULTS
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DRIVES ACTIONS
The technology determines the right time and frequency to check claim status for each payer. It simultaneously works on a batch of accounts at a time, quickly clearing your backlog. The AI continuously adapts to changing payer portals, so status checks get done — even when there are updates. It cascades through various search options to find a matching claim with a payer, ensuring high accuracy.
The AI obtains robust datasets, such as service line-level and payment information detail, to guide follow-up workflows. Advanced machine learning then accurately understands payer portal responses. We leverage our RCM experts to QA a subset of the claims, ensuring your results are interpreted correctly.
Our solution documents the status of the claim, defers it, or applies action codes based on the status. When it finds a status of no claim on file, we provide more data on why that is to help revenue cycle teams triage those claims. Our automation routes time-sensitive accounts (i.e. pending, denied, and no claim on file) to your staff or other AKASA work queues for quick follow-up. This helps your staff focus on problematic accounts, eliminating unnecessary touches.
Why AKASA Claim Status Automation
Speed up claim resolution
Proactively check on the status of claims to guide follow-up efforts on time-sensitive accounts.
Improve cash flow
Quickly respond to problematic accounts to reduce A/R days and improve speed of claim resolution.
Free staff from manual tasks
Strategically focus your team on more complex workflows. It will improve job satisfaction — and overall metrics.
Get timely information with AKASA Claim Status Automation
$30M
gross yield increase
86%
efficiency improvement
We are just getting more pennies on the dollar, because of the opportunities for our employees to work those more difficult accounts. I hadn't really thought that that was going to be a benefit. I could easily do, 'We're running these many claim statuses, so that we can eliminate this many hours of work from people.' But seeing that go to that yield was great to see and definitely brings a smile to my face.
Explore other AKASA solutions
The AKASA Platform
Superpowers for your revenue cycle
Our platform integrates advanced generative AI with our deep revenue cycle expertise. By training our models on clinical and financial data, we’re bringing you accuracy, speed, and completeness. And driving more revenue for your organization.
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