Eligibility Checks & Authorizations, Medical Claims Transmission, Payment Collection & Reconciliation, Payment Denial Appeals
Digitally Streamlining Billing and Claims Processes for Healthcare Providers
We provide a comprehensive solution that fully automates billing and claims for healthcare providers, integrating with over 250 insurers for streamlined operations.
The Problem We Attack
Health providers manually perform administrative activities of the financial cycle and this increases their costs, average collection period and causes revenue losses
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High operating cost
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Long average collection period
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Revenue loss by term
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Revenue losses due to human error
Problem statement
Insufficient interoperability between healthcare provider systems and payment sources leads to the necessity for manual work in standardizing and exchanging data between these systems. This lack of automated integration hampers accuracy in billing data exchange and results in revenue leakage.
Our Technology
Our technology solution establishes a direct digital connection between healthcare providers' HIS/ERP systems and payer entities, overcoming interoperability barriers.
This enables the automation of a wide range of administrative and financial activities that previously could not be automated.
In the Latin American healthcare sector, our technology plays a crucial role, managing 8% of the total invoicing for healthcare providers with carriers throughout Latam.
Results and ROI
Our automation solution enhances back-office operations, streamlining payment collection and reducing revenue loss due to missed deadlines and human errors.
Up to 6% revenue recovery
Up to 30 days reduction in the average collection period
Up to 70% reduction in operating costs
ROI of more than 10x
This efficiency enables our clients to reclaim over $100 million annually.
Our Platform
The iC-OS is a comprehensive and innovative operating system for the financial cycle in healthcare. It optimizes the hospital financial cycle by interconnecting healthcare providers and their payers, standing out for its high adaptability to various specific needs within the healthcare sector.
Elegibility Check & Authorization
Streamlines eligibility verifications, authorization requests, and status tracking until approvals are confirmed
Medical Claims Transmission
Automates the creation and submission of billing files and invoices, along with protocol recording in the ERP/HIS
Payment Collection & Reconciliation
Captures and organizes payment statements, identifies bank credits, and performs automatic reconciliations
Payment Denial Appeal
Automates the capture, organization, and submission of denial appeals and related documents
Our Professional Services
Payment Denial Appeal
Our Payment Denial Appeal Professional Service provides a comprehensive, outsourced solution for the operational management of payment denial appeals, ensuring:
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Process Agility: We reduce the appeal resolution time for payment denials to up to 20 calendar days, speeding up the reimbursement process and optimizing financial flow.
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Improvement in Quality and Recovery Rate: We improve the standard for appealing payment denials, increasing the average recovery rate by 20% due to a precise and well-substantiated approach.
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Cost Efficiency: We achieve a 20% to 30% reduction in operational costs with our specialized team, allowing your resources to focus on other critical areas of your operation.
Reconciliation
Our Payment Reconciliation Professional Service offers a complete, outsourced solution for the reconciliation of financial transactions, ensuring:
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Operational Agility: We finalize the reconciliations and settlements of financial transactions within 72 hours after the posting of statements and credits.
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Detailed Item-Level Reconciliation: Our reconciliation process exceeds the level of batch or global accounts; we focus on the details of each transaction, ensuring unmatched accuracy and a detailed view of financial movements.
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Cost Efficiency: We provide a 20% to 30% reduction in the operational costs of the reconciliation team.
Our Customers
Our technology is deployed across over 400 healthcare providers, encompassing some of the largest and most renowned healthcare institutions worldwide
Fourth-largest diagnostics Company in the world
One of the world’s top hospital
One of the largest hospital networks in Latam
One of Latam's top hospital
One of the largest oncology treatment groups in Latam
One of the largest hospital networks in Latam
Investors
We are backed by renowned investors as our business partners.
Contact
Book an appointment with us here
Alameda Vicente Pinzon, 54, 12th floor
Vila Olímpia, São Paulo - SP - 04547-13050