We are working on solving challenges of :
RPA ACROSS INDUSTRIES
FRAUD DETECTION IN HEALTH INSURANCE
CLAIMS MANAGEMENT IN HEALTH INSURANCE
DATA SECURITY & PRIVACY IN HEALTH INSURANCE
Products in Healthcare
POLICY HOLDER INSURANCE CO.
SVASTH PRODUCT FEATURES
The data on the fraud management system running on AI engines will be anonymized to protect patient and provider privacy. Mobile phones and Electronic Health Records (EHR) are a core requirement to avoid fraud and bring greater trust into the claim handling process, as most fraud are based upon either unwanted or redundant tests and procedures, or claims made by patients/providers on false procedures.
This would be able to automatically execute smart contracts and policies among various stakeholders in the Insurance ecosystem, for example: Hospitals, TPAs, Insurance companies, IRDAI and Insured. This would be done using a machine-readable language designed for describing, updating, accessing and communicating policies and contracts between entities and software programs.
To accelerate claims process we utilize Smart Contracts (a derivative of Blockchain Technology), which will automatically execute claims using AI, reducing load on TPA, Hospital and Insurance company. This would automatically trigger insurance authorizations and payments, once given conditions in the individual’s policy document and claims process are met. We estimate wait times would reduce from 5-8 hours to a few minutes.
Personal Health Records (PHR) has been defined as an “integrated view” of all data related to an individual across various health providers comprising of medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal stats, demographics and billing information, and multiple health apps. We suggest a Blockchain framework for protection of medical data and democratized sharing of data (in consonance with the proposed DISHA Act 2018, GDPR and HIPAA). The PHR is maintained in a secure and private environment, with the individual determining rights of access. This will be made possible through Health Data Fiduciaries (trustees) that shall facilitate consent-driven interaction between those that generate the health data and those who use PHR data.
- Research, compile and sift through large data and find the required information
- Study different cases or data of different companies and highlight parts and suggestions to find points of interest
- Restructure or streamline chunks of unstructured data for better information gathering and processing
- Handle filing of incorporation forms, tax receipts, creating invoices etc. on a regular basis
- Handle compliance forms and audit reports
- Make human-like decisions for complex processes with the help of cognitive capabilities
Leverage online / offline data sources to identify and profile prospective candidates. AI based virtual recruitment across the hiring process (right from virtual assessment / interview to employee induction) – coupled with analytical capabilities to conduct behavioral assessment, predictive success scoring and retention propensity