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Technology Solutions

There are several advantages to integrating machine learning into our processes. Our computer models achieve higher accuracy rates than traditional manual processes. These processes also improve scalability and can handle volume fluctuations more easily than traditional manual counterparts. All of this delivers consistent performance, accuracy, and efficiency.

Areas where Machine Learning is being used

Mail Processing Correspondence Identification Data Capture

Technology Solutions

Mail Processing

Machine Learning allows Smart Data Solutions’ mailroom staff to avoid the time-consuming work of manually sorting incoming mail by form and type. This process allows any staffer to quickly prepare and scan inbound mail, leaving the sorting to our automated systems. This automation improves both overall processing time and accuracy.

Technology Solutions

Correspondence Identification

Different types of correspondence need to be routed to appropriate departments or individuals, and some categories, such as appeals and legal documents, need to be processed with a higher priority than others. Our technology “learns” your correspondence mix, and can quickly and automatically identify the category, priority, and destination of thousands of documents in just minutes.

Technology Solutions

Data Capture

Normally, data fields captured with low confidence by traditional OCR engines need to be manually reviewed or keyed by a human. With our machine models we can drive down the number of fields requiring manual intervention, which provides continuous improvement in data capture accuracy and throughput.

Technology Solutions

Mail Processing

Machine Learning allows Smart Data Solutions’ mailroom staff to avoid the time-consuming work of manually sorting incoming mail by form and type. This process allows any staffer to quickly prepare and scan inbound mail, leaving the sorting to our automated systems. This automation improves both overall processing time and accuracy.

Technology Solutions

Correspondence Identification

Different types of correspondence need to be routed to appropriate departments or individuals, and some categories, such as appeals and legal documents, need to be processed with a higher priority than others. Our technology “learns” your correspondence mix, and can quickly and automatically identify the category, priority, and destination of thousands of documents in just minutes.

Technology Solutions

Data Capture

Normally, data fields captured with low confidence by traditional OCR engines need to be manually reviewed or keyed by a human. With our machine models we can drive down the number of fields requiring manual intervention, which provides continuous improvement in data capture accuracy and throughput.

Machine Learning Integration

While machine learning can be integrated into a number of different processes, the path to integration is similar across the board. Initially using a corpus of known materials, the machine-driven processes record these pilot examples. From there the models use the data to provide suggestions to human processors who make the final determinations. The machines learn from these user selections and over time the processes reach sufficient confidence and accuracy to perform the process themselves, automating certain cases. The final step comes with the machine models taking on the bulk of the work in an automated fashion only allowing the rare edge cases and the routine audit level of documents to post for human review.

22,000
documents processed per day
65,000
images processed per day
170+
different models in production
80
hours saved per week for some models
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CLIENT STORY

Debbie Ziegler

“SDS performs all of our front-end services. This includes clearinghouse, scanning, imaging, OCR and mailroom. SDS also facilitates and performs ...”
View Story
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CLIENT STORY

Brian Janssen

“Smart Data operates as the EDI clearinghouse, paper claims and enrollment intake, and 834 enrollment hub for our commercial products. The development ...”
View Story
icon

CLIENT STORY

Matthew Estes

“SDS does EDI file translation mapping, eligibility checking, and routing to/from our business partners. SDS handles a lot of the heavy lifting for us ...”
View Story

CLIENT TESTIMONY

Debbie Ziegler

Debbie Ziegler
Executive Director of Operations
“SDS performs all of our front-end services. This includes clearinghouse, scanning, imaging, OCR and mailroom. SDS also facilitates and performs automated routing to PPOs and networks, thereby ensuring that we expediently maximize client discounts. SDS also does pre-adjudication edits, such as member and provider matching. Finally, SDS provides custom IT services such as file format conversion and transfer for our Amerihealth and BCI partnership claims. SDS has a comprehensive service suite thereby allowing “one-stop shopping’ for all our front-end services. This is both cost-effective and much easier to manage. In addition, their IT aptitude allows us to fill in the gaps for one-off type projects. The process runs smoothly without much intervention. When we do have an issue they are quick to respond with a solution.”
“SDS performs all of our front-end services. This includes clearinghouse, scanning, imaging, OCR and mailroom. SDS also facilitates and performs automated routing to PPOs and networks, thereby ensuring that we expediently maximize client discounts. SDS also does pre-adjudication edits, such as member and provider matching. Finally, SDS provides custom IT services such as file format conversion and transfer for our Amerihealth and BCI partnership claims. SDS has a comprehensive service suite thereby allowing “one-stop shopping’ for all our front-end services. This is both cost-effective and much easier to manage. In addition, their IT aptitude allows us to fill in the gaps for one-off type projects. The process runs smoothly without much intervention. When we do have an issue they are quick to respond with a solution.”
View Solution

CLIENT TESTIMONY

Brian Janssen

Brian Janssen
VP, System Solutions
“Smart Data operates as the EDI clearinghouse, paper claims and enrollment intake, and 834 enrollment hub for our commercial products. The development and execution of these solutions is always done partnered with the business leaders to ensure meaningful improvements are achieved. Because of that, Smart Data is considered a valuable partner by business leaders. When we start a Smart Data initiative, as a corporate leader I do not have to worry about whether the outcome will be successful.”
“Smart Data operates as the EDI clearinghouse, paper claims and enrollment intake, and 834 enrollment hub for our commercial products. The development and execution of these solutions is always done partnered with the business leaders to ensure meaningful improvements are achieved. Because of that, Smart Data is considered a valuable partner by business leaders. When we start a Smart Data initiative, as a corporate leader I do not have to worry about whether the outcome will be successful.”
View Solution

CLIENT TESTIMONY

Matthew Estes

Matthew Estes
Chief Information Officer
“SDS does EDI file translation mapping, eligibility checking, and routing to/from our business partners. SDS handles a lot of the heavy lifting for us and allows us to focus on what we do best. No matter how complex the setup and routing, SDS has always been able to make it work for us.”
“SDS does EDI file translation mapping, eligibility checking, and routing to/from our business partners. SDS handles a lot of the heavy lifting for us and allows us to focus on what we do best. No matter how complex the setup and routing, SDS has always been able to make it work for us.”
View Solution

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Why handle the heavy lifting of your claims workflow when a smart team enhanced by AI can?

Our tools, solutions, and continued research into new AI and machine learning processes help payers nationwide reduce costs, achieve greater process efficiency, and reduce turnaround times.

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