What you need to know:
– Anomaly, a precision payments company that streamlines healthcare billing and payments for providers and payers, today announced the new Anomaly Smart Response.
– Smart Response uses AI to enable providers and payers to reduce and reprocess unavoidable claims and increase payment transparency, a priority for healthcare stakeholders. Smart Response complements Anomaly’s proposed suite of products, powered by Anomaly’s AI claims prediction engine, including Surcharge Forecasting, which enables payers to learn from past overpaid claims to predict and prevent overpayments. .
Predict claims with 97% accuracy.
The product provides suppliers with real-time feedback that predicts potential rejections and payment rates—so suppliers can remediate and avoid rejections before they happen. Smart Response works within provider workflows by integrating directly with payers, practice management software and claims clearinghouses.
Smart Response is powered by Anomaly Discovery AI claims prediction engine. The engine analyzes thousands of metrics and billions of claims to learn payer-specific rules and exceptions for each carrier. By constantly analyzing data in real-time, Smart Response stays up-to-date and automatically adapts to changing trends and new payer laws. Smart Response accurately predicts claim line failures and reasons with over 97% accuracy based on analysis of over $100 billion in payments through June 2022. The engine is specifically designed for practically evasive situations, and it achieves this best in class. An accuracy rate of up to half of total failures (recalls) across thousands of payers, all 50 states, and all lines of business (commercial, Medicare, and Medicaid). Anomaly plans to extend the engine to predict final payment amounts (real-time adjudication) and patient responsibilities, increasing transparency of the payment process for all stakeholders.
