- EnsoClaimsAI
Intelligent
and
Automatically resolve claims requiring manual
intervention using AI decision agents.
Impact Delivered
Reduction in cost per pended claim
Increase in accuracy for pended claims
Reduction in penalty risk
Increase in denials identification
Transactions processed per day per customer
Average response time for decisioning
Product Capabilities
Decision Agent Workflows
Automates pended claim resolution using AI-Powered Decision agents for deterministic or predictive or policy-based decisioning.
Real-time Decisions at Scale
Delivers real-time decisions with flexibility for decision augmentation and human-in-the-loop support.
High-Impact Pend Resolution
Resolves the highest-volume pend categories — duplicates, missing prior auths, and high-dollar claims — with tailored AI-powered resolution workflows.
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 adjudication 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.