Business Rules Engine in Healthcare Claims Automation
Automate Claims Processing and Identify Fraudulent Claims
Business Rules Engine helps in the configuration of business rules by the business users to enable automation of claim processing and identification of fraudulent/suspect claims
ClaimsLive Health, our state-of-the-art and customizable technology platform for end-to-end digital claims management and fraud detection for health insurance offers an exclusive ‘Business Rules Engine’, that is fully capable of configuring business rules for straight through processing and identification of suspect or fraudulent claims.
Business Rules Engine helps tackle the intricacy of managing a large amount of complex claims business logic calculations and manages decision processes using pre-defined logic to determine outcomes.
Explore the functionalities of Business Rules Engine Module and achieve operational excellence by identifying fraudulent claims
Group and sequence rules
Configure execution and evaluative rules
Identify and escalate suspect claims for investigation
Leverage the enhanced capabilities of the Business Rules Engine Module to help increase operational efficiency