Smart Patient Registration: Simplifies the front-end patient intake process by capturing relevant information and documentation electronically with pre-reg options, including real-time insurance eligibility verification, to avoid delays and provide the best possible patient experience with mobile based appointments and payments.

Prior Auth Identification: Applies natural language processing (NLP) and graph technology to autonomously identify certain clinical procedures which require prior authorization from the respective payer and kick starts the respective prior auth approval process, thereby cutting down significant labor time on a daily-basis and denials.

Medical Coding Automation: Automates structured and unstructured coding volumes—often the most burdensome function of RCM—with 95% or greater coding accuracy contractually guaranteed, to help reduce denials and increase reimbursements.

Denial Prediction & Prevention | Claims Automation: Analyzes historical denials, approvals, patterns or other payer behavior based on both BUDDI AI and the institution’s experience to proactively predict and prevent errors with claim submission, leading to reduced denials, faster A/R times and higher payer reimbursement. This real-time automation of the claims submissions process cuts down A/R times by 3X to 6X depending on the provider organization.

AI Driven Denials Root Cause Analysis: Analyzes revenue leakage and reduces the lead time to get reimbursed for services rendered by eliminating the potential of manual error across the billing process, including explanation of benefits (EOB) root cause analysis. Based on RARC/CARC denial codes and automatically classified into respective denial work queues, an automated first-pass analysis is completed and then dropped into respective queues for experts, if needed, to conduct manual review prior to reappeal.

Payer Contract Management & Under Payment Analysis: Onboards payer contracts and applies NLP and graph algorithms on the unstructured contract languages, mines the legal language—including pricing, expiries, sub-contract language, value-based care or Fee-For-Service contracts—and then creates a “Contextual Contract Graph” to analyze each incoming explanation of benefits (EOB) /electronic remittance advice (ERA) to identify under payments by respective payers and help reappeal those claims. Additionally, payer specific adjudication reports are generated in detail to re-negotiate contractual terms at the time of renewal.

Web-based Patient Portal and BUDDI PAY app: Improves the patient journey and helps minimize drop-off by offering one-stop web- and app-based portals for patients to see and engage in their care continuum, from registration to bill payment. On an upcoming version, patients can take snapshots of their invoice and make payments for any provider bill across all 50 states in America. BUDDI Pay could dramatically improve patience experience by being the one-stop-payment app for patients around the country irrespective of the provider’s EMR or billing system.