TrombaAI for Claims TotalAgility SaaS
TrombaAI for Claims TotalAgility SaaS Overview
Features
TrombaAI provides all the benefits and eliminates risks associated with Automation projects. With TrombaAI, the entry cost is low and remains low. Several scalable and customizable automation technologies are available and can be “turned on” at any time based on an organization’s needs.
Our TrombaAI solution is SOC 2 Type II certified.
TrombaAI for Claims
Using TrombaAI for Claims, you can process more claims in less time and with fewer resources. TrombaAI's automation intelligence will significantly improve the accuracy of your claims processing. Take control of your claim process today with TrombaAI for Claims. TrombaAI for Claims will automatically identify from an expanding document library, including CMS-1500 (HCFA), UB-04 (UB-92), and ADA Dental forms. TrombaAI will capture, extract, and validate all the data on the forms. TrombaAI can automatically notify your exception process for problem claims and provides a portal that allows providers to submit feedback and updated claims to self-service claim resolution.
TrombaAI Building Blocks
- Cloud Solution: TrombaAI is built entirely on the Azure cloud using Azure's advanced security and threat monitoring capabilities. Meet your security and compliance requirements with TrombaAI today!
- Automated Intelligence Document Processing (AIDP): Automated Intelligent Document Processing using automation technologies to intelligently automate the acquisition, understanding, and integration of all types of information across an organization, especially unstructured data in documents and emails.
- Robotic Process Automation (RPA): TrombaAI uses Tungsten RPA to automate various Connectors, such as OpenAI, Salesforce, various cloud databases, and many other cloud resources. This provides advanced Generative AI capabilities to extend automation beyond your data and documents.
- Workflow: TrombaAI provides the capabilities to create any digital workflow, business process, and dynamic case management. It's not just manual steps or queues. It could use processes that are completely automated, or you could use the right balance of automation, approval, and validation steps to create the optimal digital workflow processes.
- Enterprise Content Management: TrombaAI offers a robust Enterprise Content Management (ECM) repository that empowers both you and your customers to search for and retrieve documents securely. Our web-based Document Repository is a comprehensive solution that manages various content types. With native iOS and Android apps, you can enjoy full mobility support. Additionally, the Repository seamlessly integrates with DocuSign, SignDoc, and HelloSign for digital signature capabilities. It also supports Office 365 integration for redlining and facilitates simultaneous document collaboration.
- Self-Service Portals: TrombaAI has the ability to create internal and external user portals. Your customers and employees can easily and quickly interact with processes, documents, forms, and statuses and help resolve real-time issues.
- Generative AI (GenAI): TrombaAI utilizes Generative AI to empower our users' System of Records (SoR). You can use your data to automatically derive information that pertains to documents, information assets, and processes but doesn't exist in them. Generative AI uses data in your SoR to find more information about your documents, information assets, and processes. Then, it applies the generated data to documents and processes.
- Retrieval-Augmented Generation (RAG): TrombaAI can combine data retrieval from your System of Records (SoR) with external knowledge bases such as large language models (LLMs), reducing hallucinations and ensuring the retrieval of the most accurate and up-to-date information. And give users insight into LLM's generative results that are specific to work items and processes.
Benefits
Improve Processes and Speed Claims Reimbursement
TrombaAI 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.
Future Proof Your Business
TrombaAI for Claims is a pre-built claims solution optimized for digitization and pre-adjudication for claims, which integrates "clean claims" into your downstream adjudication process. This allows you to reap the benefits very quickly. Additionally, TrombaAI for Claims is built using flexible automation intelligence modules that provide maximum flexibility today and tomorrow. This insulates your business to the fluctuations in business and regulation changes of the future.
Improve Customer Satisfaction
TrombaAI helps to improve business relationships through greater responsiveness and transparency. This is done with a customer self-service portal that can 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 today's time. Adjudicate and pay "clean claims" quickly and accurately; all while meeting established SLAs expected by billers, insurers, and your CFO.
Best Practice Operational Analytics
TrombaAI can provide visibility into your claims processing performance. TrombaAI document intelligence 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 processor performance and leverage information to improve processing and ensure compliance.
Fast Return on Investment
TrombaAI automates steps that are manual in your current workflow. Whether it is pre-sorting on intake and validating claim data exists, from correctly identifying and routing each problem claim to conversion and routing of only "clan claims" to adjudication processing, TrombaAI automates all of that and much more. The result is efficiency, a standard set of controls, and consistent and repeatable processing that simply works while reducing cycle times and cost for every claim.
Reduce Processing Cost While Eliminating Processing Inefficiency Today
Use TrombaAI to capture and transform paper-based claims utilizing 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, EDI rules, insurer-specific rules, and master subscriber and provider data.
