Vyne Intelligent Exchange
Leveraging state-of-the-art technology to redefine the way insurance payers prioritize and optimize clinical claim reviews by automating high touch manual claim processing workflows.
What is Vyne Intelligent Exchange?
In strict adherence to the payer’s custom rules, Vyne Intelligent Exchange combines its traditional Electronic Data Interchange, its modern REST API, and Artificial Intelligence* powered by NovoDynamics to facilitate the delivery of a clean claim, with all of the requisite, legible documentation, helping payers confidently increase auto-adjudication rates, decrease operating expenses, and optimize key cost centers like clinical review.
An Intelligent Choice Uniquely Positioned Between Provider and Payer
This integrated AI service offering to payers includes notifying provider’s staff of identified correctable errors, allowing the provider to remediate identified errors including:
- Missing documentation
- Undiagnosable image quality
- Duplicate image detected
- Incorrect patient
- Incorrect dentition/anatomy
- Medical necessity evident
The Benefits of Vyne Intelligent Exchange
Vyne Intelligent Exchange utilizes Intelligent clearinghouse level preprocessing to:
- Reduce incidents of claims with insufficient documentation and requests for additional information
- Proactively identify with each image the sufficient quality and appropriate anatomy, visible tooth numbers, and duplicate or altered images
- Accurately and consistently identify claims that require review or down-coding
- Confidently increase auto-adjudication rates
- Reduce erroneously paid claims
- Optimize clinical review staff with prioritized work queue based on AI confidence and potential savings
What does this mean?
For Payers
Vyne Intelligent Exchange claims will be delivered to payers with annotations indicating that the claim has been analyzed using AI and a recommendation to either:
- Approve the claim as billed or
- Flag and prioritize the claim as a potential denial that requires further clinical review
For Providers
Vyne Intelligent Exchange empowers dental staff to preemptively remediate errors made during claim creation. Providers appreciate the upfront visibility and opportunity to eliminate potential claims processing delays.
Ready to partner with Vyne Dental and revolutionize your approach for optimizing the clinical claim review process?
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