Prediction of Claims Denial for a Revenue Cycle Management Firm
Created an algorithm that processes claims data before sending it to the payer and flags each claim for its probability of denial from the payer
Key Metrics
20% reduction in claim denial
$50K+ annual savings by avoiding rework on denied claims
78% accuracy level on denial prediction
200+ hours of effort reduced per month
Processed vast amounts of claims data through the intelligent ML algorithm by random forest method and classified the claim into three categories: Fully Paid, Fully Denied, Partially Denied. For the category of full denial and partial denial, the appropriate CARC (Claim Adjustment Reason Codes) were predicted to allow the users to understand the reasons for the denial. Our algorithm can interpret the denial codes and automate the process to correct the claims and submit them to the payers
Key Features
Claim EDI processing
Detection of denial claims
Automation of denial correction
Prediction of denial reasons
Supervised learning
Key Metrics
20% reduction in claim denial
$50K+ annual savings by avoiding rework on denied claims
78% accuracy level on denial prediction
200+ hours of effort reduced per month
Case Studies
Mobile App Development • Retail & eCommerce
Intuitive Shopfloor Management Mobile App for a Toy Manufacturer
Developed a cross-platform mobile app to automate and reduce human involvement in monitoring, operating, and scheduling manufacturing machines.
Key Metrics
45% improvement in Production Planning Efficiency
3x output through optimal Resource Scheduling
65% reduction in unplanned downtimes
100% paperless manufacturing
The app was built for remote monitoring and controlling plastic molding machines. The need for physical involvement was eliminated using automated workflows, beacons, and QR code scanners. Enabled operators to access their tasks, operate the machine with task-specific code and update the progress via the app. Integrated with peripheral production systems, combined multiple data sources, REST APIs using AWS AppSync GraphQL mutations. Created in-app analytics for tracking and optimization.
key Features
NFC & Barcode Scanning
Real-time Data Sync
Internationalization
Notifications & Alerts
Inspection & Audit Trail
Key Metrics
45% improvement in Production Planning Efficiency
3x output through optimal Resource Scheduling
65% reduction in unplanned downtimes
100% paperless manufacturing
AI & ML Automation • Manufacturing
AWS Sagemaker based Computer Vision Solution for a Manufacturer
Developed object detection at the Edge using AWS consumable production-ready services like Sagemaker, Groundtruth, IoT Greengrass, S3, and Lambda.
Key Metrics
80% efforts reduced in data annotation & labeling
65% time saved in ML Modelling
54% lower total cost of ownership
One-click deployment to the cloud
Client is required to submit the old physical devices for the new inventory fulfillment request. They wanted to replace this time-consuming process with computer vision. Configured Raspberry Pi device and made it interact with IoT Greengrass Core using Lambda. Captured images, annotated using Groudtuth, and loaded into S3 buckets. Built ML model using AWS Sagemaker built-in algorithm XGBoost. Deployed model back on Greengrass device using Lambda for object detection. Established ETL for database transformation and enabled Quick Sight insights.
key Features
Raspberry Pi Device Configuration
Video to Frames Conversion
Auto Annotation & Data Labelling
AWS Built-in-Algorithms
Image Classification Model on Edge
Key Metrics
80% efforts reduced in data annotation & labeling
65% time saved in ML Modelling
54% lower total cost of ownership
One-click deployment to the cloud
Data Management • Health Care
Member Data Management and Extraction from Payer Systems
Managed Facets administrative system from backend and created procedures to extract and manage data
Key Metrics
72% reduction in Data extraction time
98% data validation accuracy achieved
24 hour support for data warehouse management
20% reduction in manual effort through job automation
To meet the CMS compliance and data analytics requirements – member, provider, and claims data need to be processed from multiple tables. We performed data masking, anonymization, cross-referencing, duplicate removal, and business level validations at various levels. Next, we converted the data into the required format, including .txt, EDI, JSON, and other related formats. Finally, we created a data warehouse to store the data and data marts to create analytics on top of the data.
key Features
Rearchitect The System Design with Modern Tech Stack
Migration of Millions of Healthcare Records into Azure
Automated Data Validations
Data Warehouse Management
Custom File Formatting
Key Metrics
72% reduction in Data extraction time
98% data validation accuracy achieved
24 hour support for data warehouse management
20% reduction in manual effort through job automation
Hey, we are still working on those cases, they will be up soon
Please check out our other case studies in the meanwhile.
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