- EnsoPI
Intelligent
and
Identify, resolve and prevent claims errors using AI decision agents.
Impact Delivered
Reduction in COB processing time
Reduction in financial leakage
Decrease in administrative costs
Product Capabilities
Intelligent Intake
Classifies, interprets, and summarizes claim, medical record, eligibility, and contract data using rules-based logic, ML, and LLMs.
Claim Editing
Identifies claim errors and performs primary and secondary claim edits with human-in-the-loop validation and review.
COB Detection and Resolution
Detects COB cases, determines payer primacy, and resolves claims with coordinated payment adjustments.
Anomaly Detection
Detects price, cost, clinical, temporal/volume, and multidimensional outliers by synthesizing statistical, clinical and behavioral signals.
Easy Setup and
Use
Provides prebuilt, configurable agents with minimal set up.
Governance and Transparency
Ensures transparency with explainable, traceable and auditable decisions.
Seamless
Integrations
Integrates and enhances existing claims editing and payment workflows without any disruption.
From fragmented workflows
to intelligent payments.
Healthcare doesn’t need more systems. It needs better decisions across the entire payment lifecycle. By connecting prior auth, claims, appeals, and integrity into one intelligent value chain, we help healthcare organizations reduce cost, improve trust, and operate with confidence.