Capabilities
Machinify Pay identifies cost avoidance and overpayments through the aggregate of four areas:
- Coding & Policy Edits: Real-time, autonomous claim evaluation/editing solution that covers complex data mining and code editing scenarios.
- Claim Repricing: Reprice claims based on contract and fee schedule source-of-truth, while identifying and fixing potential pricing errors.
- AI Concept Development: Leverage AI to discover new concepts and translate English-language policy rules into formal code for fast deployment.
- Self-Learning Feedback Loop: Outcomes-based feedback from claims corrected downstream to auto-train and refine concepts in market.
.webp)
Benefits
Real-time editing
Machinify Pay is the most up-to-date payment system making real-time coding and policy edits against thousands of policies with built-in QA capabilities.
Autonomous repricing
Machinify Pay computes the right amount to pay for a claim at wire-speed utilizing ALL relevant payment rules and contract terms with 100% accuracy; eliminating the need for manually claim repricing.
Outsourced to insourced
Machinify Pay gives payers the ability to find payment errors at a fraction of the cost with dramatically reduced provider abrasion.
Eliminate claim backlog
Machinify removes payer's massive backlog of claims waiting for post-pay processing by dramatically increasing reviewer throughput through multi-faceted automation.
70%
65%
60%
2X
Learn from our customers
My team loves Machinify! Their AI capabilities have increased recoveries by over 30% and reduced our dependence on PI vendors. Even more, as a leader of a large PI organization, Machinify multiplied reviewer productivity while eliminating false positives.
Working with Machinify has been a uniquely positive experience. Machinify helped us identify opportunities that were previously missing and continues to serve as valuable thought partners.
Machinify is very flexible and has clearly demonstrated a track record with our payment integrity team. We couldn't ask for better partners. Internally, there is a high level of respect and trust in Machinify and when you say something, you do it.
.png)
.png)
%20(1).webp)