Appeals don’t have to drain your team’s time or test your members’ patience. In this short demo, you’ll see how our AI-driven solution, built on NewgenONE, streamlines the entire process, from intake and document handling to decision support and resolution. NewgenONE – an AI-first low-code platform integrates smoothly with your existing systems, pulling in needed information and pushing updates while keeping your enterprise in sync. Eliminate manual work, accelerate case closures, and ensure compliance every step of the way, with full transparency and control, through our low-code, customizable workflow. Get started with our ready-to-use platform right away or quickly make changes to cater to your business requirements.
What to Expect in The Demo:
- Smart Case Intake
Accept appeals through any channel, including phone, portal, fax, or mail, then let our AI categorization assistant automatically prioritize urgent cases and redirect misrouted submissions - Effortless Document Handling
Automatically flag missing info for automated follow up without user intervention and link documents to the right case - AI-backed Decision Support
Know what step to take next with our business rule guided workflow. Summarize records, track expert input, and suggest outcomes to improve decision-making and control cost - Automatic Dismissals
Let the system handle late or incomplete cases with audit-tested hyperautomation without any manual intervention - Dashboards and Audit Trails
Get complete transparency and control across each step of your appeals process, from intake to research, clinical review to claim effectuation
Why Health Plans are Making the Switch
- Case Processing & Resolution Parameters: 215% more efficient vs legacy systems
- Reporting and Auditing Parameters: 242% more efficient vs legacy systems
- Agency and Compliance: 340% more efficient vs legacy systems
- STAR Ratings: 1.5 Increase vs pre-implementation
- Platform Flexibility: Unlike Software as a Service, start with our ready-to-use platform and make changes that fit your business needs
- Predictive Intelligence: AI and ML-based predictive insights for users to make informed decisions
Turn Appeals Complexity into Confidence
Whether you’re managing 1,000 cases or 1 million, the future of healthcare appeals is automated, intelligent, and member-first.
