TrombaAI for Claims


Tromba AI for Medical, Accident, and Injury Claims

Overview

Nowadays, medical insurance companies can receive thousands of claims per day. TrombaAI strives to improve the organization and customer experience through the latest automation technology. Automating medical, accident, and injury claims processing can significantly improve the accuracy of paying medical claims, all while reducing the time and effort from processors to do that. With thousands of claims daily, automation can perform complicated processes faster and more accurately and identify risk, incomplete, and inaccurate claims. This is done with the benefits of automation, reducing processing timelines with less cost while future-proofing your business. TrombaAI can do all this and more, keeping customers engaged and well informed.

Processing claims provides deep insight into the data contained in analytic reports. The growth in automated technologies has drastically changed consumer behaviors and demands. Customers of today expect the technology of tomorrow – intelligently automated with best-in-market services. Companies that don’t embrace automation are falling behind quickly. Claims automation is a necessity to succeed and thrive in the ever-evolving market.

Benefits

TrombaAI for Claims is a pre-built medical claims solution built for pre-adjudication of medical claims and integrating "clean claims" into your downstream adjudication process. TrombaAI for Claims is built using automation intelligence modules that provide maximum flexibility today and tomorrow. This protects your business from fluctuations in business and future regulation changes.

Our TrombaAI Solution will optimize your claims processing workflow, enforce business controls, provide clear and actionable claims performance analytics, and drive continuous process improvement. Automated rules and processors can reject claims. Examiners will collaborate with billers through resolution, speeding the return and correction process. Most importantly, only "clean claims" are delivered to payment workflows, reducing adjudication exceptions and ensuring accurate payments.

TrombaAI improves business relationships through excellent responsiveness and transparency. This is done with a customer self-service portal that provides the ability to share accurate, current information with billers, subscribers, and internal customers. TrombaAI for Claims self-service portal satisfies all claim status requests from the point of capture throughout the claim process. You can identify, reject, return, and resolve claims with biller-initiated errors in a fraction of the time it takes today. Adjudicate and pay "clean claims" quickly and accurately, all while meeting established SLAs expected by billers, insurers, and your CFO.

We provide visibility into your claims processing performance. TrombaAI document and process intelligence will help you identify bottlenecks and cost-saving opportunities. TrombaAI for Claims has built-in best practice workflows, so medical coding review and approval are efficient and conform to policy. Track and analyze throughout processor performance and leverage information to improve processing and ensure compliance.

Use TrombaAI to capture paper-based claims and transform them using automated processes and intelligent verification technologies. Accurately extract and validate all subscriber, provider, and medical information, including service lines against medical code sets, NUBC, NUCC, and EDI rules, insurer-specific rules, and master subscriber and provider data.

TrombaAI automates steps that are manual in your current workflow. Whether pre-sorting on intake and validating claim data exists, from correctly identifying and routing each problem claim to conversion and routing of only "clean claims" to adjudication processing, TrombaAI automates all that and much more. The result is efficiency, a standard set of controls, and consistent, repeatable processing that works while reducing cycle time and cost for every claim.

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