Compliance Automation Regulatory Accelerator
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A well-run compliance system removes inherent manual processes, provides a better experience for the payer, provider, and member, and speeds up the investigation process.
CARA is designed for healthcare teams within the ecosystem by leading healthcare industry experts. CARA is a functioning solution that is fully customizable to meet specific state and federal guidelines with prebuilt templates and looks at the entire spectrum of interactions between payer, provider, and member. It enables compliance teams to streamline investigations, align with CMS regulations, and increase customer responsiveness. The solution is designed to remove manual processes by leveraging robotics process automation, artificial intelligence, and predictive analytics with investigations.
- Reduces penalties for non-compliance with preset service level agreements
- Eliminates the manual input process and provides rules to capture key data to initiate a case without manual intervention
- Communication with external sources for research and resolution
Robotics Process Automation
- Uses a proactive approach to manage fraud, waste, and abuse with predictive analytics while processing claims, managing appeals, and grievances, proactive approach during provider onboarding.
- Reduce manual tasks with AI, ML, and Predictive Analytics
- Enables accurate claims resolution by capturing the core data elements provided by providers/members
- Increase auto-adjudication rates, claims payment accuracy, and regulatory compliance
- Provides intuitive dashboards for reporting
- Fully customizable Federal and State Regulatory Reporting
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