Fix Inefficiencies in Claims Process

Home 9 Fix Inefficiencies in the Claims Process

Our automated systems streamline routine documents by preventing human error and reducing time-consuming costs by auto-adjudicating up to 65% of incoming documents and recognizing over 130 form types. In short, we save you from paying unrelated and duplicate bills.

APS Systems Auto-Adjudicate Up to 65% of Incoming Documents

Streamline the Routine Documents

This is how we do it:

Automatically evaluating bills for relatedness

Route all appropriate bills to the review process

Eliminate non-compensable medical costs and duplicates

On average, 32% of bills are rejected from the onset, and 58% of those never get returned. Our systems streamline your claims process and allow your adjusters to focus on high-level skilled work.

Keep Garbage Out of Your System

We typically reject up to 32% of bills from the beginning, and 58% of those never get returned. You won’t pay for unrelated bills anymore.

Our system auto-adjudicates up to 65% of incoming documents and recognizes more than 130 form types.

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Reduce Medical Loss

Our clients typically improve medical loss by 11 points, with some seeing up to a 23-point improvement.

Our automated and integrated claims system significantly reduces medical loss by examining and verifying claims every step of the way to prevent over-payment and leakage. Only verified documents are routed to the correct review process, which eliminates costs associated with unauthorized services.

Drop Medical Loss

Workers’ compensation claims go through multiple steps in multiple systems, and at each point of intersection is a chance for over-payment or leakage.

To examine and verify claims every step of the way is time-consuming and error-prone. Our integrated claims system significantly reduces medical loss.

Eliminate Claims Leakage and Overpayment

We typically reject up to 32% of bills from the beginning, and 58% of those never get returned. You won’t pay for unrelated bills anymore.

Our system auto-adjudicates up to 65% of incoming documents and recognizes more than 130 form types.

Gain Control Over Your Provider Networks

Make changes to provider networks easily

Network Transparency

APS allows you to establish a strong, diverse network with better insight into contractual commitments. Our system’s comprehensive data capture ensures accurate and consistent reporting, allowing you to instantly gain control over your provider network.

Easy Onboarding of New Partners

APS establishes a bi-directional flow of data between you and your networks, making expansion into new jurisdictions a breeze. And, because we implement, support, and maintain the solutions, the APS team can easily add providers into your network. No internal IT support required!

Problems We Solve/Increase the Power of Your Adjusters

APS automates the easy tasks, giving adjusters 40% more time to focus on the complex decisions.

On average, workers’ compensation adjusters manage 130 open cases, 20 bills from 6 different providers, 20 additional documents per claim, and are required to stay on top of 7,800 CPT codes and 68,000 ICD-10 codes. That’s a heavy load for even the most successful adjuster.

Our systems automate the easy, yet error-prone, tasks that take up a majority of an adjuster’s time. By improving efficiency, we allow them to focus on solving the difficult decisions they were trained and hired to do.

Reduce Human Error, While Keeping Sound Judgement Intact

In any system human input can be a great asset but a great risk. We understand a seasoned adjuster’s intuition is important in keeping the claim on track.

That’s why our systems automate many of the easy, yet error-prone tasks that take up too much of the adjuster’s time. The time they get back they can use to make the difficult decisions only an experienced adjuster can.

Just How Busy Are Adjusters?

APS surveyed workers’ compensation adjusters and found that their workload averages….

130 open cases

20 bills from 6 different providers, and 20 additional documents per claim

7,800 CPT codes and 68,000 ICD-10 codes to stay on top of