While members and Providers are demanding the same service experience across all channels, paper, email, efax, and accountable mail, slow down the downstream processes.
It’s time to achieve the next level of efficiency and effectiveness with Firstsource’s digital-first, digital-now approach. The Omnichannel Digital Intake solution seamlessly digitizes and transforms valuable information with AI and ML, automating the downstream processes.
Any document. Any media. Any volume.
As member’s participation increase and regulatory compliance become more demanding, manually intensive and paper-based tasks become a source of revenue loss, member dissatisfaction, as well as reputational, operational, and compliance risk. Even processes based around digital documents are only capable of keeping up with, rather than exceeding or scaling to, the rising demands of members, providers, and regulators.
Firstsource’s automated, intelligent, data-driven intake and document services give Health Plans an edge in the industry with fragmented business processes. They help to improve operational efficiency, deliver superfluid customer experience, regulatory compliance, and, ultimately, your bottom line.
The Sympraxis® platform, at the core of the digital intake solution powered by AI/ML, NLP, OCR, RPA advanced Analytics technologies, has processed Billions of pages for leading health plans. The digital intake services include mailroom services from document receipt to secure, centralized data storage to meet your needs and your members’ needs in a complex market.
Pages processed on Sympraxis® Platform
Claims data captured
Criticle field accuracy
Form Level Accuracy
Adherence to TAT
To meet your unique needs, Firstsource provides digital intake and full mailroom services for all input types, whether they’re hard copies shipped to us by you, mail delivered to a dedicated PO box or information provided to us in a variety of digital formats.
Ultra-modern scanners and document management tools are leveraged by trained document-management professionals for and digital imaging, electronic sorting, and driving data insights. Each document is classified according to Health Plan rules and tracked to ensure accuracy and traceability. Based on the client requirements, data is persisted in an intelligent, centralized repository.
Available formats include, but are not limited to, hard copy, EDI, FTP, disk, batch, email, and large formats.
Fully optimized document management requires technology that is both highly efficient and precise.
Firstsource’s high-speed scanners can process as many as 12,000 pages per hour, producing fully digitized documents without missing characters or losing legibility. Optical character recognition (OCR) and intelligent character recognition (ICR) accurately extract business-critical data for processing and indexing, with customized data capture and output tailored to suit your specific needs.
Available formats include, but are not limited to, ANSI 837, NSF, XML, and flat file.
Workflow management across multiple systems
Document indexing, member eligibility, and provider lookup
Firstsource’s proprietary Sympraxis® Automated Workflow solution automates those tasks for intelligent, data-driven operations. Not only does the workflow make data capture and classification more efficient, but it also enables automatic member eligibility determination and personalized member support with minimal, if any, manual effort.
Downstream Automation with RPA
The increased volumes and growing pressure to improve the speed to market presents significant quality challenges for manual operations.
Robotic Process Automation (RPA) reduces both time spent on repetitive processes and the chance for human error. Intelligent, rule-driven, and working from a centralized data repository, RPA helps provide the efficiency, speed, and accuracy that members, providers, and regulators demand.
The insights captured from documents also provide an opportunity to drive the frictionless workflows for downstream operations such as Claims, Appeals, Provider Data Management, Membership and Billing, Prior-Authorization, and Quality Management.
From the very first document, Firstsource’s document management process is tailored to your needs. Through Machine Learning and Artificial Intelligence (AI), the process becomes even more efficient and customized over time. With each document processed, our auto-adaptive system becomes more intelligent and sensitive to your needs, able not only to manage documents efficiently but to move claims through the system faster while meeting member needs more effectively.
The platform automatically captures indexed data from the unstructured document using AI technology and verifies data against code sets, member, and provider records. It automatically ranks the results with a proprietary algorithm for quick lookup and selection. Complete transparency into operations is enabled by Sympraxis® real-time visual reports on your workflow, including turnaround times, daily productivity figures, and more.