Improving Healthcare outcomes with
Trusted AI
Our AI Applications improve patient outcomes while lowering operating costs through predictive, proactive and personalized care.
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Healthcare Applications
CognitiveScale’s AI Applications include Healthcare-specific products that accelerate Member and Patient engagement in areas like care optimization (e.g. cost of care, Star Rating Improvement) and service experience. Process improvement Applications in Healthcare improve claims and program integrity (fraud, waste and abuse) processes.
Service Experience
- Chatbot
- Self Service
- Agent Assist
- Intelligent Call Routing
Care Optimization
- High Cost Claims
- Care Interventions
- Star Rating Improvements
Claims Transformation
- Claims Exception Automation
- Real-time Adjudication
- Fraud, Waste & Abuse
Sales Acceleration
- Intelligent Lead Gen
- Plan Match
- Medicare Conversion
Inclusion Advocacy
- Care Inclusion
- Coverage Inclusion
- Collections Inclusion
Healthcare AI solutions leveraging patient, member, provider, and claim profiles
CognitiveScale’s Profile of One is a 360-degree, temporal, longitudinal view of key entities (Patients, Members, Providers, Agents, Claims, etc.). Profiles form a key foundation for personalized insights and proactive interventions. These profiles are built out leveraging Healthcare-specific accelerators like data connectivity (e.g. APIs) and schemas common in the payer and provider segments.