AI Roster Automation | Faster, Accurate, and Compliant Provider Data

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MCheck™ Roster-Automation

Touchless end-to-end roster processing with AI

Overview

Automated roster ingestion, standardization, and data quality checks for greater efficiency and better provider relations

Impact on Health Plan’s Operations

20000+ Provider organization rosters standardized

Less than 48 Hours Turnaround Time Reduced

Eliminate Compliance Risk Under the No Surprise Act

Explore how a large national Blue Plan effectively managed escalating costs to drive success

Operational Margin: $80M Savings

HiLabs created savings of $80M in one year by automating roster management work done by 1000s of people

Operational Efficiency:Eliminated Backlog with 99% Accuracy

HiLabs’ AI-driven solution, powered by proprietary healthcare-specific LLMs, intelligently extracts key attributes from diverse delegated roster formats and standardizes data into health plan-specific formats

Compliance: TAT < 48 hours

By automating updates in under 48 hours, HiLabs eliminates compliance risks, helping payers effortlessly adhere to the ‘No Surprise Act’ and maintain operational integrity

Explore the AI-driven capabilities redefining provider workflows for streamlined operations

Operational efficiency for scale

Zero-Touch Scaling

Eliminate manual roster mapping for growing provider volumes. Integrate seamlessly with virtually any upstream credentialing system or roster ingestion platform

Roster.AI

An AI-powered assistant specifically trained on thousands of rosters, designed to function as a SME. Extract actionable insights and accurately answer questions related to roster operations for streamlined and enhanced decision-making

Rapid turnaround time for compliance

Precision for provider satisfaction

Operational efficiency for scale

Zero-Touch Scaling

Eliminate manual roster mapping for growing provider volumes. Integrate seamlessly with virtually any upstream credentialing system or roster ingestion platform

Roster.AI

Why invest in AI-driven roster processing?

Traditional ETL and rules-based engines fall behind

Limited Scalability

Rule-based engines require expensive coding and maintenance to handle routine changes in provider rosters, often requiring extensive manual intervention to manage processing.

Error-Prone Processes

ETL pipelines are limited in their data quality checks, increasing the likelihood of provider mismatches, data duplication, and downstream claims denials.

High Maintenance Costs

Frequent updates to rules and workflows demand IT resources, slowing down operations and increasing overall costs.

How AI outperforms Traditional Systems

Error Detection and Correction

Advanced AI algorithms adapt seamlessly to routine roster changes, identify anomalies, flag potential data errors, and correct inaccuracies in real time, ensuring 99% data accuracy.

Scalable Automation

effortlessly to manage the increasing provider data volumes and complexities associated with larger networks, M&A activities, and changing roster formats.

Proactive Intelligence

Predictive capabilities anticipate and resolve potential issues before they escalate, reducing backlogs and improving operational efficiency.

Future-proofing through interoperability

Seamless Data Exchange

Investing in AI aligns your organization with interoperability standards, ensuring smooth integration with upstream credentialing, downstream claims systems, and external, provider-facing channels.

Alignment with Advances in Healthcare

AI-driven platforms support modern healthcare initiatives like value-based care by ensuring accurate and up-to-date provider information is available across the network.

Regulatory Readiness

Built-in compliance tools ensure adherence to emerging regulations, like CMS interoperability mandates, keeping your organization ahead of the curve.

Try our solution today