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ease
features
design
support

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Description

Five Sigma embarked on a quest to empower claims organizations to embrace innovation. Their collection of claims management tools and distinctive platform equips insurers with what is necessary to adapt their claims operations to an ever-evolving environment. By offering a suite of Claims-First Cloud-Native and User-Centric products, Five Sigma enhances the capabilities of adjusters, enabling them to manage claims more effectively and swiftly. Through the automation of routine administrative tasks, adjusters can concentrate on making informed decisions while the system efficiently manages the rest. Introducing Clive™ by Five Sigma, the first AI-driven claims adjuster in the industry, is revolutionizing the claims processing landscape for insurers, MGAs, and TPAs. By harnessing cutting-edge AI and automation, Clive optimizes the entire claims lifecycle, from the First Notice of Loss (FNOL) to the final settlement. This AI agent not only boosts the efficiency of claims handling but also improves accuracy and reduces costs by automating various tasks, ultimately leading to a more streamlined and effective process for all stakeholders involved. In this way, Five Sigma is setting a new standard for the future of claims management.

Description

Ensure a steady stream of revenue by utilizing a robust platform that accelerates reimbursements through eligibility verification, tracking claims status, conducting audits and appeals, and managing remittances for both government and commercial claims, all integrated into one cohesive system. Take advantage of a sophisticated rules engine that promptly cleanses claims in accordance with the latest CMS and commercial payer regulations, enabling you to rectify any inaccuracies prior to submission. During the claim upload process, confirm eligibility across all payers and identify any flagged issues, allowing for necessary edits before the claims are sent. Reduce the days in accounts receivable by implementing automated workflows for handling audit responses, submitting appeals, and tracking administrative dispute resolutions. Tailor staff workflow assignments based on the specific claim type and required actions. Additionally, automate the submission of secondary claims to prevent timely filing write-offs. Ultimately, enhance your claims revenue through automated workflows that facilitate quicker and more successful audits and appeals, ensuring your organization remains financially healthy. Furthermore, this comprehensive system can adapt to your evolving needs, providing long-term benefits as your operations grow.

API Access

Has API

API Access

Has API

Screenshots View All

Screenshots View All

Integrations

Inovalon Provider Cloud

Integrations

Inovalon Provider Cloud

Pricing Details

No price information available.
Free Trial
Free Version

Pricing Details

No price information available.
Free Trial
Free Version

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Vendor Details

Company Name

Five Sigma

Country

United States

Website

www.fivesigmalabs.com

Vendor Details

Company Name

Inovalon

Founded

1998

Country

United States

Website

www.inovalon.com/products/provider-cloud/revenue-cycle-management/all-payer-revenue-cycle-management/

Product Features

Claims Processing

Adjustor Management
Case Management
Claim Resolution Tracking
Co-Pay & Deductible Tracking
Compliance Management
Customer Management
Electronic Claims
Forms Management
Paper-Based Claims
Payor Management
Policy Administration

Insurance Agency

Claims Management
Commission Management
Contact Management
Document Management
Insurance Rating
Life & Health
Policy Management
Property & Casualty
Quote Management

Insurance Claims Management

CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting

Product Features

Insurance Claims Management

CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting

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