Chenoa
"Chenoa continues to deliver solutions that improve our operations at a cost that makes sense!"
- Director Information Services,
Local Government Agency
AUTOMATED CLAIMS ADJUDICATION
Cost Effective and Adaptable Rules Engine Technology

Claims processing can either be a source of escalating cost and risk or it can be a strategic source of customer insight and business intelligence. At Chenoa our Claims solutions create opportunity, drive operational decisions based on facts and add value throughout your enterprise.

Our Claims Auto-Adjudication technology is architected as an open system that minimizes ongoing support costs so that you can make strategic investments into your marketing plans, operations, people and customers. With our Claims technology platform our clients can quickly attack their most pressing Claims Adjudication transactions, improve performance and efficiency and then strategically expand the rules engine scope and purpose.

Creating a Claims Ecosystem

As a partner our goal is to create a Claims Ecosystem that is built on a flexible architecture, streamlined workflow, responsive to business needs and is based on detailed data analytics.

   

Creating a Claims Ecosystem starts with our client’s vision and outcomes. We collaborate with technology and business users to achieve consensus on rules definitions. As we define business rules we make sure that they are expressed in enough detail to be unequivocal while remaining comprehensible. Overall we take an iterative approach to our Discovery, Construction and Deployment phases producing tangible results throughout the process.

   

Benefits:

  • Cut claim payment cycles for Auto-Adjudicated claims by 70 percent
  • Increase auto-adjudication rates and accuracy
  • Reduced time to add new payor or provider by 60 percent
  • Exponentially increase claims processing capacity with existing staff
  • Shorter time to implement business rule changes
  • Improved claims processing accuracy by 90 percent
  • Business rules changed without changes to operational systems software

Technologies:

  • Service Oriented Architecture
  • Microsoft BizTalk Server ESB
  • JBoss Drools Business Logic Integration Platform