LYNNFIELD, Mass., Jan. 31, 2022 /PRNewswire/ — AMS, a healthcare affordability software company that provides clinical insights and financial analysis of the costliest and most complex medical claims is excited to announce the launch of AI-Bill. The end-to-end solution leverages Natural Language Processing (NLP), Artificial Intelligence (AI) and Machine Learning (ML) to compile benchmarked line items costs into a user-friendly Implant Review Worksheet.
Additionally, the Implant Review Worksheet integrates relevant data from AMS’ PredictIx module to further facilitate the auditing process. Compiled information includes FDA classifications complete with categories and implant and supply charges; implants that are not FDA approved; unsupported implant billings; unexpected unit quantities for the charged procedure; markup of billed charge and the variance compared to the actual cost of the charge.
Capable of reading over 75 different I-Bill formats, AI-Bill’s three-step process begins with AI-Bills’ Auto-Screener that uses NLP to quickly identify all implants within an itemized bill PDF file. The file then leverages AI to reconcile identified line items with data from AMS’ PredictIx module that contains actual provider paid cost information on over 2 million implants. Finally, AI-Bill generates a user-friendly Implant Review Worksheet in under 2 minutes, substantially streamlining the manual bill review process.
"AI-Bill is a game changer for claim auditors. The amount of ever-growing implant data housed in the AMS Predict Platform is the perfect resource to benchmark billed implant charges and provide the supporting data that reviewers need to quickly and effectively complete an audit," said Peter Borans, CEO, AMS. "It’s cutting-edge technology that will forever change the way implant billing audits are performed."
AMS’ AI-powered Predict Platform is the industry’s first cloud-based enterprise software to integrate custom modules that target price transparency, clinical insights, and financial benchmarks. Focused solely on analyzing the most expensive and complex claims and accompanying financial impact, AMS provides Health Plans, MGUs, TPAs and Stop-Loss Carriers with enterprise benefits to help improve medical spend and positively impact healthcare affordability. We believe that "Knowledge is Power." www.mdstrat.com