The WhiteHatAI Centaur: Built for Pre-Adjudication

The WhiteHatAI Centaur is built from the ground up to help facilitate a shift to pre-adjudication and pre-payment

 

 

 

The Focus on Medical Billing Pre-Payment

For the best results, payers position the WhiteHatAI Centaur System in their work flow before payment, either prior to or during adjudication. Unlike rules-based systems, the WhiteHatAI Centaur can delve deep into medical billing data and find not only known irregularities, but also unknown and emerging schemes that rules-based analytics may not recognize. 

The WhiteHatAI Centaur System reviews hundreds of thousands of data points, examining thousands of variables in various combinations simultaneously to detect unusual fraud patterns that emerge, even new and previously unknown patterns. But the WhiteHatAI Centaur takes this a step further and then provides reasons, evidence and contextual information so investigators and analysts can make rapid, informed decisions.  


WhiteHatAI’s medical billing pre-payment approach helps payers:


  • Drive down costs from invalid or inappropriate claims
  • Reduce payment errors before they are even paid
  • Avoid payment delays for claims deemed legitimate
  • Improve processes for more accurate data
  • Systematically remove unnecessary costs in the claims process
  • Improve capital position by retaining funds earlier in the process
  • Eliminate medical billing “Pay and Chase” scenarios