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Decision Intelligence for

Healthcare

Decision Intelligence for Healthcare is your gateway to improving productivity and processing claims accurately and quickly.

The results are fast—reduced administrative costs, increased capacity utilization, and a significant productivity boost—plus, your people are happier, more motivated, and cross-skilled.

ActiveOps helps you to match resources, work and time, to meet your SLAs across Claims, Members and Provider services.

Driven by predictive and prescriptive AI, Decision Intelligence for Healthcare surfaces the insights and recommendations you need to make better decisions across your teams.

Are you struggling to match capacity to claim inventory?

Are you struggling to do more with less?

Can you reduce standard times for claims, provider and member services?

Can you flex your resources across your departments to manage peaks and troughs?

Are you optimizing costs post MLR and delivering more?

Do you know exactly where your human and digital workers are spending their time and effort right now?

We work with many of the leading healthcare payers in North America. Our experience spans x years, and our approach and methodology (AOM), which supports Decision Intelligence, is proven globally across the insurance and banking sectors.

AVERAGE
CAPACITY GAIN

20%
IN 1ST YEAR

CLAIMS PROCESSING
14.1%
IMPROVEMENT

SAVED
$7M
IN FIRST 9 MONTHS

HARD
53 FTE
SAVINGS

INVESTMENT IN UPSKILLING
6.3 FTE
STAFF P/M

MORE STORIES

Ops leaders must fix data issues to glean benefits of AI

New US research reveals the state of operations in healthcare

Ops leaders must fix data issues to glean benefits of AI

New US research reveals the state of operations in healthcare

Decision Intelligence for Healthcare supports operations across many use cases

Whatever your use case needs, we can help. Our solutions work across back and front office. We help you see where your employees are spending their time and how to optimize your teams to drive increased performance.

Claims Management

Provider Services

Medical Management

Provider Credentialing

Enrollment

Resolutions (G&A)

Utilization Management

Payment Integrity

Member and Plan Enrollment

Our Product Suite

Relevant and consistent data significantly improves visibility. The ActiveOps operations data model is built for service ops and sits within our products, providing you with one source of truth for all your decisions.

Intelligence for Transactional Service Ops

Prescriptive, AI-driven analytics that identifies hidden capacity and utilization, and prompts action to drive effectiveness and control.

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Intelligence for case-driven teams

Predictive analytics to keep casework and SLAs on track. Real-time view, real-time decisions.

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Employee and wellbeing Intelligence

Diagnostic insights highlight what is impacting performance, work and employee experience.

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Discover how we can help you:

Meet all your SLAs across Claims, Members and Provider services
Improve decision-making, know when are where your staff are working
Support capacity and skills planning
Respond proactively to staff wellbeing insights