AI-as-a-Service for Payment Integrity

Power up Your Payment Integrity Reviews with Flexible AI Services

Take your clinical chart reviews to the next level with relevant condition insights delivered right within your existing workflows and applications.

Trustworthy Intelligence Drives Repeatable Results

To scale payment integrity programs and take advantage of pre-pay arrangements, health plans need technology to help identify relevant clinical insights within patient charts, streamline review workflows, and apply customized rules and routing tailored to their internal and provider partner needs.

Apixio’s AI-as-a-Service for Payment Integrity is a flexible analytics solution that helps clinical chart reviewers quickly and accurately locate relevant condition intelligence to support DRG validation and other payment integrity programs.
Streamline Clinical Chart Reviews
Increase Reviewer Accuracy And Speed
Leverage AI Insights In Existing Workflows
Benefits

Faster Claims and Chart Reviews

Our natural language processing (NLP) engine extracts, normalizes, and organizes clinical data so reviewers can complete audits more quickly.

Flexible and Adaptable Rules and Routing

Control every rule and edit with our highly configurable models that support your unique plan and provider partner needs.

Integrate Insights Seamlessly

Send AI-powered diagnosis insights to your existing systems using flexible, interoperable APIs.

Maintain Control of Your Process

Leverage external insights to power up your clinical chart review process—no new technology or workflows are needed.

Features

NLP data extractions that streamline claim determinations

Deliver clinical insights to your workflows using flexible JSON APIs

Access diagnosis and procedure details in a structured format for simplified clinical determinations

Scale Your Payment Integrity Program Impact with Apixio

Explore how Apixio can support your organization’s unique payment integrity program needs.