Talix, a leading SaaS healthcare information technology company delivering risk adjustment and quality solutions for value-based care, today announced the launch of its new Claims InSight application. As an integral add-on to the powerful Talix Platform, Claims InSight works alongside Talix’s flagship application, Coding InSight, to help payer organizations further reduce financial risk and achieve even greater time and cost savings through faster, more accurate code submissions.
Both Coding InSight and Claims InSight are powered by the advanced Talix Platform, which combines machine learning with purpose-built natural language processing (NLP) technology, a sophisticated clinical rules engine, and an extensive clinical taxonomy. Coding InSight leverages this platform to nearly automate manually intensive chart reviews and, in the process, intuitively flag any codes that are missing documentation or supporting evidence. Claims InSight now takes the next step, enabling users to apply the same technology platform workflow to match flagged codes directly to clinical encounters and member chart data. As a result, coders can quickly fill in documentation gaps or delete incorrect codes, all within a unified workspace.
“We are excited for Talix’s Claims InSight platform as it will greatly help Medical Mutual of Ohio save a lot of time that we have to spend now sifting through claims data in multiple systems, which has been tedious and laborious,” said Katy Davis, Manager, Risk Adjustment Medical Coding at Medical Mutual of Ohio. “We have to work in multiple systems and spreadsheets, as well as pdf’s, in order to perform delete work today. Talix’s Claims InSight puts everything we need in one place to quickly and efficiently delete incorrect codes and manage supplemental opportunities concurrently.”
Health plan executive leadership and boards can rest easy knowing more accurate and complete code submissions are achieved, helping reduce organizational risk. “Customers spoke, we listened, and we acted: No more working in separate spaces or applications,” said Dean Stephens, Chief Executive Officer of Talix. “Claims InSight quickly analyzes an entire submitted claim and identify any opportunities to address and prepare for a potential RADV audit. As always, Talix is committed to serving customer needs and advancing the efficiency and accuracy of risk management programs across the healthcare industry.”
Talix customers with existing Coding InSight implementations can easily add Claims InSight to their platforms. New Talix customers can now purchase both Coding InSight and Claims InSight in a combined deployment. For more information on features, or to schedule a demo, please visit www.talix.com/HealthPlanSolutions.
Talix is a leading SaaS healthcare information technology company delivering risk adjustment and quality solutions to help providers and payers succeed in value-based healthcare. Our platform delivers easy-to-use workflow applications that leverage multiple integrated technologies, including purpose built natural language processing (NLP), machine learning and advanced patient data analytics. This platform transforms complex patient data into actionable intelligence that drives improved efficiency and accuracy—leading to better patient outcomes, accurate reimbursements and improved efficiencies. For more information, please visit www.talix.com or follow @TalixHealth on Twitter.