AArete unveils AI-powered Payment Intelligence, offering solution for health plans

AArete, a global management and technology consulting firm, announced its next generation payment intelligence solution. AArete’s Payment Intelligence has been engineered to navigate the complex provider contracts, plan policies, regulations and industry standards. The solution accommodates the business decisions of  company policies and health plans, while integrating critical details of provider contracts, such as rates and complex carve outs.

Payment Intelligence accelerates review of claims and configuration across six critical pillars of payment accuracy, with one data feed and multiple analytic methods in one integrated solution. The platform uses advanced claims analytics, a proprietary DoczyTM tool, and AI/ML models to find and fix the root cause of costly claims challenges at scale. The AI/ML models learn and adapt to new requirements and regulations at both the national and state level. They also incorporate plan-specific policies and contractual obligations into smart claims processing.

Payment Intelligence aims to offers health plans a fast track to ROI. The client delivery team ensures rapid onboarding, reducing false positives, and swiftly translating insights into tangible value for clients. Beyond CMS, Payment Intelligence comprehensively addresses regulatory requirements (extending to state-specific rules) and can be  customised for each client.