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Claims Management

Decision making tool for pre-authorization that enables automated coverage and completeness checks, and advanced quote analysis thanks to medical coding coherence and pricing benchmarks.

What
we offer

  • Automated extraction of relevant information and using trained AI to determine relevant coverage check details from underlying term/conditions and policies database
  • Automated decision based on matching the provided claims information and the trained conditions
  • Quote analysis using benchmarking & pricing analysis and medical coding coherence checks
  • Qantev patient journey analysis to check if service is necessary & suitable
  • Alternative provider recommendation for SMO
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QUOTE ANALYSIS

Pre-authorisation analysis report

Qantev provides comprehensive quote analysis using pricing benchmark and medical coding coherence checks. Claims manager also gets insights about patient journey.

PROVIDER RECOMMENDER

Alternative provider recommendation

Using historical claims, patient profile and multiple data points, Qantev can help identify the best alternative provider for referrals or second medical opinions.

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NORMALISED QUOTE
TABLE

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PROVIDER
SERVICE QUALITY

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ALTERNATIVE
PROVIDER RECOMMENDATION

How
We Do It

Qantev’s multiple highly specialised technological assets are enabling straights through processing capabilities thanks to automated coverage and completeness checks, while improving customer experience with quicker communication.

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